Organization
MARK P HASTINGS, DPM, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK P HASTINGS DPM (PRESIDENT)
(414) 873-0772
Entity
Organization
Contact information
Practice address
3431 N 51ST BLVD, MILWAUKEE, WI 53216-3228
(262) 255-1040
(262) 255-4090
Mailing address
N86W16462 JACOBSON DR, MENOMONEE FALLS, WI 53051-2833
(262) 255-1040
(262) 255-4090
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41722300
—
WI
01
—
4248430001
MEDICARE DME
WI
05
—
43214100
—
WI
Enumeration date
09/01/2006
Last updated
07/15/2009
Update your record
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