Provider Demographics
NPI:1154434181
Name:KOTCHEN, JANE M (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:M
Last Name:KOTCHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:E
Other - Last Name:MORLEY KOTCHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8701 W WATERTOWN PLANK RD
Mailing Address - Street 2:DEPARTMENT OF POPULATION HEALTH CLINIC
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3548
Mailing Address - Country:US
Mailing Address - Phone:414-955-8201
Mailing Address - Fax:414-955-6554
Practice Address - Street 1:8701 W WATERTOWN PLANK RD
Practice Address - Street 2:DEPARTMENT OF POPULATION HEALTH CLINIC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3548
Practice Address - Country:US
Practice Address - Phone:414-955-8201
Practice Address - Fax:414-955-6554
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI332842083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1154434181Medicaid
WI1154434181Medicaid