Individual
RANCE JAY HAFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3500
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37502
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37502
LICENSE
WI
Enumeration date
12/05/2005
Last updated
02/27/2014
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