Individual
ROSS HAZLEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
340 ENTERPRISE DRIVE, MARKESAN, WI 53946
(920) 398-2321
(920) 398-2952
Mailing address
340 ENTERPRISE DRIVE, MARKESAN, WI 53946
(920) 398-2321
(920) 398-2952
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30950-021
WI
208600000X
Surgery Physician
30950-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30047100
—
WI
Enumeration date
08/09/2005
Last updated
10/24/2014
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