Roberts, Kevin D

Roberts, Kevin D is an individual health care provider with primary practice located at 1700 W Stout St , Rice Lake WI 54868-5000. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Roberts, Kevin D can be contacted via phone (715) 236-8100.

Contact Information

Primary practice address
1700 W Stout St Rice Lake WI 54868-5000
Phone: (715) 236-8100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC003533L Pennsylvania
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 927 Wisconsin

Profile Details

NPI number 1336147446
LBN Legal business name Roberts, Kevin D
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Apr 25th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336147446 NPPES
Wisconsin MEDICAID 43242000
Wisconsin MEDICAID 0014689160003

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