Hallett, Mark

Hallett, Mark is an individual health care provider with primary practice located at 820 E Grant St , Appleton WI 54911-3483. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Hallett, Mark can be contacted via phone (920) 831-5050.

Contact Information

Primary practice address
820 E Grant St Appleton WI 54911-3483
Phone: (920) 831-5050
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 34228 Wisconsin

Profile Details

NPI number 1629098504
LBN Legal business name Hallett, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Feb 2nd, 2011 - about 13 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 1629098504 NPPES
Wisconsin MEDICAID 31944600

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