Healthcare Provider Details

I. General information

NPI: 1063521714
Provider Name (Legal Business Name): LEE W HASH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 S MADISON ST
APPLETON WI
54915-1800
US

IV. Provider business mailing address

2223 LIME KILN RD STE 1
GREEN BAY WI
54311-6213
US

V. Phone/Fax

Practice location:
  • Phone: 920-996-3700
  • Fax:
Mailing address:
  • Phone: 920-430-8113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number21111
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number49731
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: