Provider Demographics
NPI:1720276066
Name:ALAN A. HYMAN, MD
Entity Type:Organization
Organization Name:ALAN A. HYMAN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-975-1133
Mailing Address - Street 1:16140 HORTON RD
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7937
Mailing Address - Country:US
Mailing Address - Phone:773-975-1133
Mailing Address - Fax:
Practice Address - Street 1:16140 HORTON RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7937
Practice Address - Country:US
Practice Address - Phone:773-975-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI24838207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1750387684OtherMEDICARE PROVIDER NPI
WI1720276066OtherMEDICARE DME PRACTICE NPI
WI1750387684OtherMEDICARE PROVIDER NPI
WI5105450001Medicare NSC