Provider Demographics
NPI:1356486591
Name:HASLER, GALEN R (MD)
Entity Type:Individual
Prefix:
First Name:GALEN
Middle Name:R
Last Name:HASLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 S HAMILTON ST
Mailing Address - Street 2:203
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3861
Mailing Address - Country:US
Mailing Address - Phone:608-206-5218
Mailing Address - Fax:
Practice Address - Street 1:350 S HAMILTON ST
Practice Address - Street 2:203
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3861
Practice Address - Country:US
Practice Address - Phone:608-206-5218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50861-20207RH0003X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A11665Medicare UPIN