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NPI Code Detail

MEDICARE: JOHN S HONISH MD

MEDICARE: JOHN S HONISH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician15275WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255364543
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN S HONISH MD
Provider Business Mailing Address
First Line : PO BOX 19070
Second Line : PREVEA HEALTH
City : GREEN BAY
State : WI
Zip : 54307-9070
Country : US
Telephone Number : 920-496-4700
Fax Number : 920-496-4705
Provider Business Practice Location Address
First Line : 620 SMITH AVE
Second Line :
City : OCONTO
State : WI
Zip : 54153-1080
Country : US
Telephone Number : 920-496-4700
Fax Number : 920-496-4705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 07/08/2007

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Directions to “ JOHN S HONISH MD” Practice Location

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