Provider Demographics
NPI:1477532091
Name:HESSE, DAVID F (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:HESSE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 W. HAMILTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6970
Mailing Address - Country:US
Mailing Address - Phone:715-514-4706
Mailing Address - Fax:715-514-4708
Practice Address - Street 1:719 W HAMILTON AVE STE A
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6970
Practice Address - Country:US
Practice Address - Phone:715-514-4706
Practice Address - Fax:715-514-4708
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI725213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43221500Medicaid
WI43221500Medicaid
WI5904570001Medicare NSC
WI000182327Medicare PIN