Brian J Hettrick (NPI# 1942262712, PAC ID# 0143259481) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1942262712 |
| PAC ID by PECOS | 0143259481 |
| Professional Enrollment ID | I20050809000137 |
| Full Name | Brian J Hettrick |
| Address |
10400 75th St Kenosha WI 53142-7884 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | HOSPICE/PALLIATIVE CARE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520021 | UNITED HOSPITAL SYSTEM |
| 520189 | AURORA MEDICAL CENTER KENOSHA |
| Address | Phone | Organization |
|---|---|---|
| 10400 75th St, Kenosha, WI 53142-7884 | ||
| 3506 Washington Rd, Brookside Care Center, Kenosha, WI 53144-1654 | ||
| 9555 76th St, Pleasant Prairie, WI 53158-1984 | ||
| 7137 236th Ave, Suite 103, Salem, WI 53168-9664 |
| Street Address |
10400 75TH ST |
| City | KENOSHA |
| State | WI |
| Zip | 53142-7884 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David B Kite | Physician Assistant | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Brian A Schroeder | Nurse Practitioner | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Peter J Bartzen | General Surgery | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Jeffrey A Greene | Physician Assistant | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Markian J Kuzycz | General Surgery | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Kenneth M Niec | Physician Assistant | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Mohan Prabu Ayyaswamy | Neurology | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Melissa A Wingate | Psychologist, Clinical | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Sarah N Stachon | Physician Assistant | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Keven R Mottinger | Physician Assistant | Aurora Medical Group Inc | 10400 75th St, Kenosha, WI 53142-7884 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Randall J Hammett | Chiropractic | 6500 67th St, Kenosha, WI 53142-1403 | |
| Laurie Sasso | Clinical Social Worker | Wellqor Psychological Services of Wisconsin, S.c. | 6300 67th St, Kenosha, WI 53142-1437 |
| Rodrigo B Mata Iii | Internal Medicine | 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142-2927 | |
| Nancy Guadagno | Clinical Social Worker | 6123 Green Bay Rd, Suite 240, Kenosha, WI 53142-2927 | |
| Shellie Kaye Babcock | Clinical Social Worker | 6123 Green Bay Rd, Suite 240, Kenosha, WI 53142-2927 | |
| Chad E Sloden | Chiropractic | Sports and Family Chiropractic LLC | 6123 Green Bay Rd, Suite 140, Kenosha, WI 53142-2927 |
| Nicholas Joseph Hollendonner | Chiropractic | Sports and Family Chiropractic LLC | 6123 Green Bay Rd, Suite 140, Kenosha, WI 53142-2927 |
| Pushparanee Babusukumar | Psychiatry | Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr | 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928 |
| Tom A Defrancesco | Clinical Social Worker | Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr | 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928 |
| Donna J Hayes | Podiatry | 6125 Green Bay Rd, Suite 600, Kenosha, WI 53142-2928 | |
| Find all physicians in zip 53142 | |||
| City | KENOSHA |
| Zip Code | 53142 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | KENOSHA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Brian J Hettrick.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.