Harbor Medical & Associates SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25744-020 Issued in WI

Legal business name

HARBOR MEDICAL & ASSOCIATES SC

Practice address

4810 Northwestern Ave
Racine, WI 53406-1504

Phone

(262) 637-2050

Fax

(262) 637-3910

NPI assigned

Jun 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fredric Will, MD

Title

Owner

Phone

(262) 637-2050

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1457554990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 NORTHWESTERN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534061504",
            "telephone_number": "262-637-2050",
            "fax_number": "262-637-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 NORTHWESTERN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534061504",
            "telephone_number": "262-637-2050",
            "fax_number": "262-637-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR MEDICAL & ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "WILL",
        "authorized_official_first_name": "FREDRIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-637-2050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "25744-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30531900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Sue Hansen, OTR
• Mary S. Hansen, PT
• Patti Hansen
• Brittany Hanson
• Stephanie B Hanson, LCSW
• Jerry M. Hardacre II, M.D.
• David Lawrence Harenke I, DDS
• Corie Hargrove, CADC-III
• Paige Harpenau
• Ashli Harris

• Psychiatry Physician in Racine, WI
• Providers in Racine, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.