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General NPI Number Information
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NPI Number | 1912297102
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Entity Type | Individual
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Provider Name | KATHLEEN ANTONY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2011
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 3014 STAMFORD PL
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City | FITCHBURG
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State | WI
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Zip | 53711-6938
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Country | US
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Telephone | 623-578-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 3014 STAMFORD PL
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City | FITCHBURG
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State | WI
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Zip | 53711-6938
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 64024
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License Number State | WI
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