Individual
JOHN GANSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2809 N PARK DRIVE LN, APPLETON, WI 54911-1603
(920) 738-4600
(920) 738-4792
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38921
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30084200
—
WI
Enumeration date
06/27/2006
Last updated
07/08/2007
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