Provider Demographics
NPI:1629024047
Name:MIDDLETON, KATHRYN L (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2844 INDEX RD
Mailing Address - Street 2:ST. MARY'S SLEEP CENTER
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53713-3117
Mailing Address - Country:US
Mailing Address - Phone:608-229-7979
Mailing Address - Fax:608-229-8110
Practice Address - Street 1:2844 INDEX RD
Practice Address - Street 2:ST. MARY'S SLLEP CENTER
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53713-3117
Practice Address - Country:US
Practice Address - Phone:608-229-7979
Practice Address - Fax:608-229-8110
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35843-020207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32080200Medicaid
WI4189OtherDEAN HEALTH INSURANCE
WI4189OtherDEAN HEALTH INSURANCE
F23346Medicare UPIN
WI32080200Medicaid