Provider Demographics
NPI:1437133824
Name:KAISER, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:KAISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-6926
Mailing Address - Country:US
Mailing Address - Phone:920-237-5000
Mailing Address - Fax:920-237-5001
Practice Address - Street 1:600 N WESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-6926
Practice Address - Country:US
Practice Address - Phone:920-237-5000
Practice Address - Fax:920-237-5001
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8092207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1773889-01Medicaid
WI000471129OtherMEDICARE PTAN
TX9323362OtherPRIVATE HEALTHCARE SYST
WI000471129OtherMEDICARE PTAN
TX9323362OtherPRIVATE HEALTHCARE SYST