Dr. Robert Joseph Defatta
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon Pediatric Otolaryngology Plastic Surgeon (Head & Neck) and 5 more
1490 Rivers Edge Trail
Altoona
, Wisconsin 54720-1495
Dr. Robert Joseph Defatta
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon Pediatric Otolaryngology Plastic Surgeon (Head & Neck) and 5 more
1490 Rivers Edge Trail
Altoona
, Wisconsin 54720-1495
(715) 828-2368
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Pediatric Otolaryngology
- Facial Plastic Surgeon
- Plastic Surgeon (Head & Neck)
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Dr. Robert Joseph Defatta
- 1490 Rivers Edge Trail
- Altoona, WI
- Zip : 54720-1495
- Phone : (715) 828-2368
Second Address
- Dr. Robert Joseph Defatta
- 1490 Rivers Edge Trail
- Altoona, WI
- Zip : 54720-1495
- Phone : (715) 828-2368
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Y00000X | Otolaryngologist (ENT Doctor) | 243412 | NY |
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 55984-20 | WI |
| N | 207YP0228X | Pediatric Otolaryngology | 243412 | NY |
| N | 207YP0228X | Pediatric Otolaryngology | 55984 | WI |
| N | 207YS0123X | Facial Plastic Surgeon | 243412 | NY |
| N | 207YS0123X | Facial Plastic Surgeon | 55984 | WI |
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | 243412 | NY |
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | 55984 | WI |
| N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 243412 | NY |
National Provider Identifier
| NPI | 1578697520 |
|---|---|
| Provider Name | Dr. Robert Joseph Defatta |
| First Address | Altoona, WI 54720-1495 |
| Second Address | Altoona, WI 54720-1495 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/03/2007 |
| Last Update Date | 20/12/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.