Kingsfield, David Walter
Kingsfield, David Walter is an sole proprietor health care provider with primary practice located at 2357 W Mason St , Green Bay WI 54303-4708. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Kingsfield, David Walter can be contacted via phone (920) 337-6740.Contact Information
Primary practice address
2357 W Mason St
Green Bay WI 54303-4708
Phone: (920) 337-6740
Fax: (920) 337-6741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 16049-132 | Wisconsin |
Profile Details
| NPI number | 1174869283 |
|---|---|
| LBN Legal business name | Kingsfield, David Walter |
| Credentials | CSAC CSIT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 17th, 2012 |
| Last updated | Sep 12th, 2018 - about 8 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 | 1174869283 | NPPES |
| Wisconsin | MEDICAID | 100060438 |
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