Individual
JACOB RUSSELL HAGENBUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1 S PARK ST, MADISON, WI 53715-1375
(608) 287-2700
(608) 287-2722
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1162
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
DP1188152
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275927576
—
WI
Enumeration date
03/24/2015
Last updated
12/12/2024
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