Robert J Defatta (NPI# 1578697520, PAC ID# 0345335675) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
Nation Provider ID (NPI) | 1578697520 |
PAC ID by PECOS | 0345335675 |
Professional Enrollment ID | I20111205000260 |
Full Name | Robert J Defatta |
Organization Legal Name | DEFATTA ENT AND FACIAL PLASTIC SURGERY SC |
Address |
1490 Rivers Edge Trl Altoona WI 54720-2755 |
Phone Number | 7158282368 |
Gender | M |
Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
Graduation Year | 2002 |
Primary Specialty | OTOLARYNGOLOGY |
Group Practice PAC ID | 6103059936 |
Number of Group Practice Members | 4 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
520196 | OAKLEAF SURGICAL HOSPITAL |
520013 | SACRED HEART HOSPITAL |
521333 | BLACK RIVER MEMORIAL HOSPITAL |
Address | Phone | Organization |
---|---|---|
1490 Rivers Edge Trl, Altoona, WI 54720-2755 | 7158282368 | DEFATTA ENT AND FACIAL PLASTIC SURGERY SC |
Organization Legal Name | DEFATTA ENT AND FACIAL PLASTIC SURGERY SC |
Physicians | 4 |
Name | Specialty | Organization | Address |
---|---|---|---|
Timothy A Lippold | Qualified Audiologist | Defatta Ent and Facial Plastic Surgery Sc | 1490 Rivers Edge Trl, Altoona, WI 54720-2755 |
Emily C Barquest | Qualified Audiologist | Defatta Ent and Facial Plastic Surgery Sc | 1490 Rivers Edge Trl, Altoona, WI 54720-2755 |
Rima A Defatta | Otolaryngology | Defatta Ent and Facial Plastic Surgery Sc | 1490 Rivers Edge Trl, Altoona, WI 54720-2755 |
Street Address |
1490 RIVERS EDGE TRL |
City | ALTOONA |
State | WI |
Zip | 54720-2755 |
Name | Specialty | Organization | Address |
---|---|---|---|
Timothy A Lippold | Qualified Audiologist | Defatta Ent and Facial Plastic Surgery Sc | 1490 Rivers Edge Trl, Altoona, WI 54720-2755 |
Emily C Barquest | Qualified Audiologist | Defatta Ent and Facial Plastic Surgery Sc | 1490 Rivers Edge Trl, Altoona, WI 54720-2755 |
Rima A Defatta | Otolaryngology | Defatta Ent and Facial Plastic Surgery Sc | 1490 Rivers Edge Trl, Altoona, WI 54720-2755 |
Name | Specialty | Organization | Address |
---|---|---|---|
Tj Nereng | Physical Therapy | Northwoods Sport and Hand Inc | 1200 Oakleaf Way, Suite B, Altoona, WI 54720-2245 |
Phillip J Porter | Neurosurgery | Chippewa Valley Orthopedics and Sports Medicine Clinic Sc | 1200 Oakleaf Way A, Altoona, WI 54720-2245 |
Nathan Hoadley Harris | Orthopedic Surgery | Chippewa Valley Orthopedics and Sports Medicine Clinic Sc | 1200 Oakleaf Way A, Altoona, WI 54720-2245 |
Kamal Thapar | Neurosurgery | Chippewa Valley Orthopedics and Sports Medicine Clinic Sc | 1200 Oakleaf Way A, Altoona, WI 54720-2245 |
Ryan D Stearns | Physical Therapy | Northwoods Sport and Hand Inc | 1200 Oakleaf Way, Suite B, Altoona, WI 54720-2245 |
Jose Abran Padilla | Orthopedic Surgery | Chippewa Valley Orthopedics and Sports Medicine Clinic Sc | 1200 Oakleaf Way A, Altoona, WI 54720-2245 |
Nathaniel J Stewart | Orthopedic Surgery | Chippewa Valley Orthopedics and Sports Medicine Clinic Sc | 1200 Oakleaf Way A, Altoona, WI 54720-2245 |
Jaramia Matthew Jehn | Physical Therapy | Northwoods Sport and Hand Inc | 1200 Oakleaf Way, Suite B, Altoona, WI 54720-2245 |
Kris A Gessert | Physical Therapy | Northwoods Sport and Hand Inc | 1200 Oakleaf Way, Suite B, Altoona, WI 54720-2245 |
Carie L Steil | Physical Therapy | Northwoods Sport and Hand Inc | 1200 Oakleaf Way, Suite B, Altoona, WI 54720-2245 |
Find all physicians in zip 54720 |
City | ALTOONA |
Zip Code | 54720 |
Specialty | OTOLARYNGOLOGY |
City + Specialty | ALTOONA + OTOLARYNGOLOGY |
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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.