Provider Demographics
NPI:1427007624
Name:COUSSONS, HERBERT S (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:S
Last Name:COUSSONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2411 HOLMGREN WAY
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-5224
Mailing Address - Country:US
Mailing Address - Phone:920-888-2828
Mailing Address - Fax:888-876-4773
Practice Address - Street 1:2411 HOLMGREN WAY
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5224
Practice Address - Country:US
Practice Address - Phone:920-888-2828
Practice Address - Fax:888-876-4773
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI43795-020207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology