Healthcare Provider Details

I. General information

NPI: 1730166901
Provider Name (Legal Business Name): NEZIH Z HASANOGLU D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 W NATIONAL AVE STE 202
WEST ALLIS WI
53227-2145
US

IV. Provider business mailing address

10150 W NATIONAL AVE STE 202
WEST ALLIS WI
53227-2145
US

V. Phone/Fax

Practice location:
  • Phone: 262-782-5662
  • Fax: 262-782-5296
Mailing address:
  • Phone: 262-782-5662
  • Fax: 262-782-5296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25286
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number25286
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: