Hettrick, Brian J

Hettrick, Brian J is an individual health care provider with primary practice located at 8400 Washington Ave , Mount Pleasant WI 53406-3735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hettrick, Brian J can be contacted via phone (262) 884-4088.

Contact Information

Primary practice address
8400 Washington Ave Mount Pleasant WI 53406-3735
Phone: (262) 884-4088
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 41149 Wisconsin

Profile Details

NPI number 1942262712
LBN Legal business name Hettrick, Brian J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Feb 13th, 2024 - about 10 months 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 1942262712 NPPES
Wisconsin MEDICAID 32558300
Wisconsin Other P00248375

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