Healthcare Provider Details

I. General information

NPI: 1164423844
Provider Name (Legal Business Name): DOUGLAS HEMPEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N BARKER RD 110
BROOKFIELD WI
53045-5929
US

IV. Provider business mailing address

601 N BARKER RD 110
BROOKFIELD WI
53045-5929
US

V. Phone/Fax

Practice location:
  • Phone: 262-785-0777
  • Fax: 262-785-0610
Mailing address:
  • Phone: 262-785-0777
  • Fax: 262-785-0610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number42869
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: