Healthcare Provider Details

I. General information

NPI: 1760328108
Provider Name (Legal Business Name): HANNES HEPPNER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 JOHN Q HAMMONS DR STE 101
MADISON WI
53717-2911
US

IV. Provider business mailing address

700 S PARK ST STE A
MADISON WI
53715-1830
US

V. Phone/Fax

Practice location:
  • Phone: 608-260-6000
  • Fax: 608-260-2961
Mailing address:
  • Phone: 608-260-6000
  • Fax: 608-260-2961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number5540-57
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: