NPI 1063673903

Mary Patricia Eldridge, MD

Practitioner General Practice Physician Kenosha, WI

Practice location

Address: 1400 75th St Suite #5, Kenosha, WI 53143-1544
Phone: (262) 656-1911
Fax: (888) 316-8458

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 54685-20 (WI)

Other General Practice providers in Wisconsin →

Registry record

NPI: 1063673903
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jun 2008
Record last updated: 19 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.