Individual
KENT B HARTUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-8492
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33943
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31894700
—
WI
01
—
P01589743
RAILROAD MEDICARE
WI
Enumeration date
03/14/2006
Last updated
10/22/2020
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