Garrison, Kenneth Joe
Garrison, Kenneth Joe is an individual health care provider with primary practice located at 105 4Th Ave , Shell Lake WI 54871-0189. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Garrison, Kenneth Joe can be contacted via phone (715) 468-2711.Contact Information
Primary practice address
105 4Th Ave
Shell Lake WI 54871-0189
Phone: (715) 468-2711
Fax: (715) 468-2727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 45490 | Wisconsin |
Profile Details
| NPI number | 1316945512 |
|---|---|
| LBN Legal business name | Garrison, Kenneth Joe |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316945512 | NPPES |
| Wisconsin | MEDICAID | 34380700 | |
| Wisconsin | Other | 266R9GA |
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