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NPI Code Detail

MEDICARE: JOSEPH A DIETZLER MD

MEDICARE:   JOSEPH A DIETZLER  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 Physician48541WI

General Provider Information

NPI Number : 1760450456
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH A DIETZLER MD
Provider Business Mailing Address
First Line : 2651 HILLCREST DRIVE
Second Line : SUITE 303
City : HUDSON
State : WI
Zip : 54016-4439
Country : US
Telephone Number : 715-531-6800
Fax Number : 715-531-6801
Provider Business Practice Location Address
First Line : 525 N KNOWLES AVE
Second Line : SUITE 100
City : NEW RICHMOND
State : WI
Zip : 54017-1218
Country : US
Telephone Number : 715-531-6800
Fax Number : 715-531-6801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 05/31/2023

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Directions to “ JOSEPH A DIETZLER MD” Practice Location

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