Individual
DR. DOUGLAS J HENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904
(920) 303-8700
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
69114
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30730800
MEDICAID
WI
05
—
30730800
—
WI
05
—
3285138
—
MI
Enumeration date
09/06/2006
Last updated
03/30/2023
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