MEDICARE: DR. JANE M. KOTCHEN 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
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	33284	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154434181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE M. KOTCHEN MD

Provider Business Mailing Address
First Line	:	8701 W WATERTOWN PLANK RD
Second Line	:	DEPARTMENT OF POPULATION HEALTH CLINIC
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3548
Country	:	US
Telephone Number	:	414-955-8201
Fax Number	:	414-955-6554

Provider Business Practice Location Address
First Line	:	8701 W WATERTOWN PLANK RD
Second Line	:	DEPARTMENT OF POPULATION HEALTH CLINIC
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3548
Country	:	US
Telephone Number	:	414-955-8201
Fax Number	:	414-955-6554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	11/06/2012

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