DOUGLAS B HORAN (NPI# 1063406965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063406965 |
| Entity Type | Individual |
| Full Name | DOUGLAS B HORAN |
| Credential | MD |
| Practice Address |
1550 Midway Pl Menasha WI 54952-1165 |
| Practice Telephone | 9207278153 |
| Mailing Telephone | 9207278153 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 28242 | WI | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
28242 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30798400 | 05 |
| Street Address |
1550 MIDWAY PL |
| City | MENASHA |
| State | WI |
| Zip Code | 54952-1165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557666 | Eric C Gowing | Internal Medicine | 1550 Midway Pl, Menasha, WI 54952-1165 | 2005-09-06 |
| 1205485257 | Brittany Luteyn | Physical Therapist | 1550 Midway Pl, Menasha, WI 54952-1165 | 2019-09-11 |
| 1669952297 | Megan E Abler | Nurse Practitioner | 1550 Midway Pl, Menasha, WI 54952-1165 | 2018-08-14 |
| 1275029589 | Katherine Sarah Laszkiewicz | Physician Assistant | 1550 Midway Pl, Menasha, WI 54952-1165 | 2018-07-10 |
| 1427583657 | Michelle Wenzel | Occupational Therapist | 1550 Midway Pl, Menasha, WI 54952-1165 | 2017-04-25 |
| 1508225194 | Amy Handler | Occupational Therapist | 1550 Midway Pl, Menasha, WI 54952-1165 | 2016-02-11 |
| 1609276237 | Alyssa Tollefson | Physical Therapist | 1550 Midway Pl, Menasha, WI 54952-1165 | 2014-09-02 |
| 1922425040 | Kunal Patel | Ophthalmology | 1550 Midway Pl, Menasha, WI 54952-1165 | 2014-03-26 |
| 1164843876 | Elizabeth Schleitwiler | Occupational Therapist | 1550 Midway Pl, Menasha, WI 54952-1165 | 2013-12-23 |
| 1487080446 | Carol A Veltus | Nurse Practitioner | 1550 Midway Pl, Menasha, WI 54952-1165 | 2013-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275776239 | Sharon Louise Crowe | Dental Hygienist | 1814 North Appleton Road, Menasha, WI 54952 | 2009-04-07 |
| 1003056110 | Nicole Marie Guyette | Dental Hygienist | 814 N. Appleton Road, Menasha, WI 54952 | 2009-03-02 |
| 1760627624 | Jan Charles Sarnecki | Orthopaedic Surgery | 1814 N. Appleton Road, Menasha, WI 54952 | 2008-12-08 |
| 1588828297 | Lesley R Lathrop | Registered Nurse | 1764 Oakridge Court, Menasha, WI 54952 | 2008-07-11 |
| 1699965137 | Lisa Randerson | Counselor | 1427c Province Terrace, Menasha, WI 54952 | 2007-07-31 |
| 1689748675 | Lisa Lynn Lang Riegel | Dentist | 1155 Wittman Drive, Menasha, WI 54952 | 2006-11-20 |
| 1164596144 | Robert Charles Lang | Dentist | 1155 Wittmann Drive, Menasha, WI 54952 | 2006-11-20 |
| 1366527947 | Karen Patricia Schmidt | Case Manager/Care Coordinator | 1810 Appleton Road, Menasha, WI 54952 | 2006-10-25 |
| 1376647388 | Goodwill Industries of North Central Wi | Counselor | 1800 Appleton Road, Menasha, WI 54952 | 2006-09-11 |
| 1386135614 | Leslie J Steckbauer | Counselor | 1095 Midway Rd, Menasha, WI 54952 | 2018-05-22 |
| Find all providers in zip 54952 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605880 | Forefront Dermatology Sc | Dermatology | W7713 Johnson Ct, Wautoma, WI 54982-5274 | 2020-10-05 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1417105545 | Forefront Dermatology, S.c. | Dermatology | 3515 Murray Street, Marinette, WI 54143 | 2008-09-03 |
| 1588857247 | Forefront Dermatology, S.c. | Dermatology | 1400 Scheuring Road, De Pere, WI 54115 | 2007-08-24 |
| 1083768253 | Forefront Dermatology, S.c. | Dermatology | 3935 N Lightning Dr, Appleton, WI 54913 | 2007-01-23 |
| 1003356692 | Forefront Dermatology, S.c. | Dermatology | 17100 W North Ave, Suite 200, Brookfield, WI 53005 | 2017-03-01 |
| 1477001956 | Forefront Dermatology, S.c. | Dermatology | 8501 75th St, Suite J, Kenosha, WI 53142 | 2016-09-14 |
| 1215483201 | Forefront Dermatology, S.c. | Dermatology | 10500 W Loomis Rd, Suite 110, Franklin, WI 53132 | 2016-08-30 |
| 1275913006 | Maxim Alexandrovich Polansky | Dermatology | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2015-06-06 |
| 1013350958 | New Dermatology Group Ltd | Dermatology | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2013-04-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.