Provider Demographics
NPI:1891809422
Name:HAUSER, RUSSELL R (DC)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:R
Last Name:HAUSER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N80W14942 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3868
Mailing Address - Country:US
Mailing Address - Phone:262-253-0200
Mailing Address - Fax:262-255-7986
Practice Address - Street 1:N80W14942 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3868
Practice Address - Country:US
Practice Address - Phone:262-253-0200
Practice Address - Fax:262-255-7986
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
35410-0002Medicare ID - Type Unspecified
WIT62150Medicare UPIN