Healthcare Provider Details

I. General information

NPI: 1912273020
Provider Name (Legal Business Name): DANIEL J HEHLI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 WHIPPLE ST
EAU CLAIRE WI
54703-5270
US

IV. Provider business mailing address

200 1ST ST SW
ROCHESTER MN
55905-5002
US

V. Phone/Fax

Practice location:
  • Phone: 715-838-5222
  • Fax:
Mailing address:
  • Phone: 715-838-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number65114
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: