Provider Demographics
NPI:1720283138
Name:HASTINGS, MARK P (DPM)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:P
Last Name:HASTINGS
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:3431 N 51ST BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-3228
Mailing Address - Country:US
Mailing Address - Phone:414-873-7668
Mailing Address - Fax:414-873-3933
Practice Address - Street 1:3431 N 51ST BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3228
Practice Address - Country:US
Practice Address - Phone:414-873-0772
Practice Address - Fax:414-873-3933
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2013-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI659025213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist