Healthcare Provider Details

I. General information

NPI: 1649248022
Provider Name (Legal Business Name): BARBARA R HOSTETLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COMPASSION WAY
DODGEVILLE WI
53533-1956
US

IV. Provider business mailing address

800 COMPASSION WAY
DODGEVILLE WI
53533-1956
US

V. Phone/Fax

Practice location:
  • Phone: 608-930-8000
  • Fax:
Mailing address:
  • Phone: 608-930-8000
  • Fax: 608-930-7251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number40457
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: