Gassner, John R

Gassner, John R is an individual health care provider with primary practice located at 1789 Shawano Ave , Green Bay WI 54303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gassner, John R can be contacted via phone (920) 499-1428.

Contact Information

Primary practice address
1789 Shawano Ave Green Bay WI 54303
Phone: (920) 499-1428
Fax: (920) 499-5808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 28941020 Wisconsin

Profile Details

NPI number 1588600696
LBN Legal business name Gassner, John R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Oct 8th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588600696 NPPES
Michigan Other 4723988 MICHIGAN MEDICAID
Michigan Other 1018745003 MICHIGAN MEDICAID
Michigan Other 4767178 MICHIGAN MEDICAID
Michigan Other 14404 MICHIGAN MEDICAID
Michigan Other 300020918 MICHIGAN MEDICAID
Michigan MEDICAID 31496900 MICHIGAN MEDICAID
Michigan Other 1018745002 MICHIGAN MEDICAID
Michigan Other 567565 MICHIGAN MEDICAID

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