Healthcare Provider Details

I. General information

NPI: 1023234705
Provider Name (Legal Business Name): ROBERT CLIFTON KUEHL R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

N79W16384 LONGWOOD ST
MENOMONEE FALLS WI
53051-7322
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-6501
  • Fax:
Mailing address:
  • Phone: 262-250-9687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9569-040
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: