Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35488-20 | WI |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 35488-20 | WI |
NPI | 1386608966 |
---|---|
Provider Name | Gregory K Hartig |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 06/01/2021 |