Healthcare Provider Details

I. General information

NPI: 1306849443
Provider Name (Legal Business Name): ROBERT J. BECHARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E BELL ST
NEENAH WI
54956-4993
US

IV. Provider business mailing address

119 E BELL ST
NEENAH WI
54956-4993
US

V. Phone/Fax

Practice location:
  • Phone: 920-969-1768
  • Fax: 920-969-1788
Mailing address:
  • Phone: 920-969-1768
  • Fax: 920-267-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number31422
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number131422
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: