Eldridge, Eugene John

Eldridge, Eugene John is an individual health care provider with primary practice located at 1400 75Th St Suite 3, Kenosha WI 53143-1544. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Eldridge, Eugene John can be contacted via phone (262) 652-9500.

Contact Information

Primary practice address
1400 75Th St Suite 3 Kenosha WI 53143-1544
Phone: (262) 652-9500
Fax: (262) 652-0760
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 25921 Wisconsin

Profile Details

NPI number 1932284296
LBN Legal business name Eldridge, Eugene John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932284296 NPPES
Wisconsin MEDICAID 31384000

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