Provider Demographics
NPI:1144428236
Name:THE KENNEDY CENTER FOR THE HIP AND KNEE S.C.
Entity Type:Organization
Organization Name:THE KENNEDY CENTER FOR THE HIP AND KNEE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYCISIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-223-0123
Mailing Address - Street 1:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54957-0381
Mailing Address - Country:US
Mailing Address - Phone:920-223-0123
Mailing Address - Fax:920-223-0370
Practice Address - Street 1:2700 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7247
Practice Address - Country:US
Practice Address - Phone:920-223-0123
Practice Address - Fax:920-223-0370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty