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Individual

KEVIN DOUGLAS LIBERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
709 SPRING VALLEY RD, BURLINGTON, WI 53105-7614
(262) 767-6020
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1305
WI
213E00000X
Podiatrist
SC007059
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100224481
WI
Enumeration date
01/02/2020
Last updated
01/19/2026
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