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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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