Debra Joy Blodgett, DC
Individual provider Active NPI Chiropractor · Hartford, WI
NPI 1083728893 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1083728893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3293 (WI)
- Practice address
- 23 S Main St
Hartford, WI 53027-1867 - Phone
- (262) 673-6764
- Fax
- (262) 673-6845
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3293 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3293 | WI | Yes |
Addresses
Primary practice location
23 S Main St
Hartford, WI 53027-1867
Mailing address
23 S Main St
Hartford, WI 53027-1867
Phone (262) 673-6764
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38892400 | Medicaid | WI |
Other providers in Hartford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.