MEDICARE: MARK A HOENECKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	28943	WI
2	207L00000X	Anesthesiology Physician	28943-020	WI

General Provider Information

NPI Number	:	1073562286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A HOENECKE MD

Provider Business Mailing Address
First Line	:	3785 JANELLE LN
Second Line	:
City	:	COTTAGE GROVE
State	:	WI
Zip	:	53527-9569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3785 JANELLE LN
Second Line	:
City	:	COTTAGE GROVE
State	:	WI
Zip	:	53527-9569
Country	:	US
Telephone Number	:	88-395-7466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	04/11/2023

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Directions to “ MARK A HOENECKE MD” Practice Location

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