Provider Demographics
NPI:1043262298
Name:HASLER, PHILIP J (OD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:HASLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 21ST ST
Mailing Address - Street 2:STE F
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-1022
Mailing Address - Country:US
Mailing Address - Phone:608-524-4303
Mailing Address - Fax:608-524-4028
Practice Address - Street 1:1104 21ST ST
Practice Address - Street 2:STE F
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-1022
Practice Address - Country:US
Practice Address - Phone:608-524-4303
Practice Address - Fax:608-524-4028
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2241-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1043262298Medicaid
WIP01479680Medicare PIN
WIK400177156Medicare PIN
WI1006615OtherPHYSICIANS PLUS
T83423Medicare UPIN
WI60120OtherDEAN HEALTH INSURANCE