Individual
THOMAS A GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 W KINNICKINNIC PKWY, 630, MILWAUKEE, WI 53215-5212
(414) 385-7111
Mailing address
2801 W KINNICKINNIC RIVER PKWY STE 680, MILWAUKEE, WI 53215-3669
(414) 385-7111
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
31257
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006976
KAISER-COMMERCIAL NUMBER
—
05
—
01312578
—
CO
05
—
1952528366
—
WI
Enumeration date
04/19/2007
Last updated
01/11/2019
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