Individual
ERIC S. GAENSLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 PORT WASHINGTON ROAD, SUITE 110, GRAFTON, WI 53024-9201
(262) 387-8300
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
36678
WI
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
36678
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32140000
—
WI
01
—
P00452791
RR MEDICARE
WI
Enumeration date
07/01/2006
Last updated
08/07/2024
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