Kwon, Tai H

Kwon, Tai H is an individual health care provider with primary practice located at 430 E Division St , Fond Du Lac WI 54935-4560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Kwon, Tai H can be contacted via phone (920) 926-2300.

Contact Information

Primary practice address
430 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-2300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 24197 Wisconsin

Profile Details

NPI number 1356327019
LBN Legal business name Kwon, Tai H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated May 12th, 2008 - about 16 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 1356327019 NPPES
Wisconsin MEDICAID 30416400
Wisconsin Other P00064340

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