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Organization

DJ KONTRA MD & ASSOCIATES SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENNIS J KONTRA MD (PRESIDENT)
(262) 886-9100
Entity
Organization

Contact information

Practice address
5802 WASHINGTON AVE, STE 102, RACINE, WI 53406-4050
(262) 886-9100
(262) 886-9130
Mailing address
5802 WASHINGTON AVE, STE 102, RACINE, WI 53406-4050
(262) 886-9100
(262) 886-9130

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32784900
WI
01
CT1058
RAILROAD MEDICARE
WI
Enumeration date
10/21/2005
Last updated
04/25/2008
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