Doctor Name: | DR. MARTIN L. JANSSEN |
NPI Number: | 1417926023 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 13648 |
Business Practice Address: | 402 W Lake St Friendship, WI - 539349699 |
Business Phone Number: | 6083393331 |
Business Fax Number: | 6083396975 |
Mailing Address: | Po Box 40, FRIENDSHIP |
State: | WI |
Postal Code: | 539340040 |
Phone Number: | 6083393331 |
Fax Number: | 6083396975 |
NPI Enumeration Date: | 03/16/2006 |
NPI Last Update Date: | 08/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13648 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |