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Contact Information

MARK HALLETT, MD
820 E GRANT ST
APPLETON, WI54911-3483
 Phone: 920-831-5050
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MARK HALLETT · (Male)

NPI # 1629098504
Status Active
Credentials MD
Entity Individual
Enumeration date 07/20/2006
Last updated 02/02/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 34228
  • WI Medicaid 31944600
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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