Individual
SCOTT KENNETH HETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-5770
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 361-5770
(920) 361-5779
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
73446-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2018
Last updated
07/22/2021
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