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NPI Code Detail

MEDICARE: DR. JEFFREY DENNIS KUETER MD

MEDICARE: DR. JEFFREY DENNIS KUETER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036112131IL
2207Q00000XFamily Medicine Physician036-112131IL
3207Q00000XFamily Medicine Physician70754-20WI

General Provider Information

NPI Number : 1154317295
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY DENNIS KUETER MD
Provider Business Mailing Address
First Line : 1450 EASTSIDE RD
Second Line :
City : PLATTEVILLE
State : WI
Zip : 53818-9800
Country : US
Telephone Number : 608-348-4330
Fax Number :
Provider Business Practice Location Address
First Line : 1450 EASTSIDE RD
Second Line :
City : PLATTEVILLE
State : WI
Zip : 53818-9800
Country : US
Telephone Number : 608-348-4330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 11/17/2020

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