Provider Demographics
NPI:1154352078
Name:QUINN, KEVIN FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:FRANCIS
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1147 GLENAYRE DR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4235
Mailing Address - Country:US
Mailing Address - Phone:920-585-9707
Mailing Address - Fax:866-805-6467
Practice Address - Street 1:1147 GLENAYRE DR
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4235
Practice Address - Country:US
Practice Address - Phone:920-585-9707
Practice Address - Fax:866-805-6467
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2019-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI21812208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30468200Medicaid
WI71278Medicare ID - Type Unspecified
WI30468200Medicaid