Hendricks, Douglas J
Hendricks, Douglas J is an individual health care provider with primary practice located at 5320 West Michaels Drive , Appleton WI 54913. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Hendricks, Douglas J can be contacted via phone (920) 882-8200.Contact Information
Primary practice address
5320 West Michaels Drive
Appleton WI 54913
Phone: (920) 882-8200
Fax: (920) 882-8210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 36950-020 | Wisconsin |
Profile Details
| NPI number | 1700878824 |
|---|---|
| LBN Legal business name | Hendricks, Douglas J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Feb 21st, 2013 - about 12 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 | 1700878824 | NPPES |
| Wisconsin | MEDICAID | 34027500 |
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