Wyne, Kevin T

Wyne, Kevin T is an individual health care provider with primary practice located at 600 Highland Ave , Madison WI 53792-0001. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Wyne, Kevin T can be contacted via phone (608) 262-2398.

Contact Information

Primary practice address
600 Highland Ave Madison WI 53792-0001
Phone: (608) 262-2398
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 001734 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 055.0030930 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085002558 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2909-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085002558 Illinois

Profile Details

NPI number 1699757880
LBN Legal business name Wyne, Kevin T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Apr 19th, 2023 - about 3 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 1699757880 NPPES
Wisconsin MEDICAID 100024390
Wisconsin Other 28783

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