Individual
JAMES R BARGENQUAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 735-7645
(920) 735-7618
Mailing address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-4101
(920) 830-5970
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15491
AZ
208M00000X
Hospitalist Physician
Primary
22956
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15491
AZ STATE MEDICAL LICENSE
AZ
05
—
288721
—
AZ
01
—
AZ0769140
BCBSAZ
AZ
Enumeration date
06/19/2006
Last updated
08/09/2023
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