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Contact Information

DIANE G HEATLEY, MD
3050 BOSSHARD DR
FITCHBURG, WI53711-5860
 Phone: 608-273-0375
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Otolaryngology

207YP0228X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for DIANE G HEATLEY · (Female)

NPI Number 1396793444
Status Active
Credentials MD
Entity Individual
Enumeration date 05/04/2006
Last updated 05/25/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 29448-20
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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