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Individual

JOHN A BAZLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
43785
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1042503
PHYSICIANS PLUS
01
15300226
MEDICARE PART B
01
34157700
HIRSP
05
34157700
WI
01
390808509
CIGNA
01
390808509CT
UNITY
01
690004890
MEDICARE RAILROAD
01
DEAN HEALTH PLAN
13434
01
P00034839
MEDICARE RAILROAD
Enumeration date
07/20/2006
Last updated
12/28/2020
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