Provider Demographics
NPI:1376653295
Name:HUITING, KARL D (DC)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:D
Last Name:HUITING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 N LYNNDALE DR
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3085
Mailing Address - Country:US
Mailing Address - Phone:920-733-9330
Mailing Address - Fax:920-733-7220
Practice Address - Street 1:811 N LYNNDALE DR
Practice Address - Street 2:SUITE 1B
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3085
Practice Address - Country:US
Practice Address - Phone:920-733-9330
Practice Address - Fax:920-733-7220
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3686 012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38928000Medicaid
U82142Medicare UPIN
WI000470535Medicare ID - Type Unspecified