Provider Demographics
NPI:1184800880
Name:BUZOGANY, WILLIAM M (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:BUZOGANY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:LAD LAKE INC
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118
Mailing Address - Country:US
Mailing Address - Phone:262-965-2131
Mailing Address - Fax:262-965-4107
Practice Address - Street 1:W350 S1401 WATERVILLE ROAD
Practice Address - Street 2:LAD LAKE INC
Practice Address - City:DOUSMAN
Practice Address - State:WI
Practice Address - Zip Code:53118
Practice Address - Country:US
Practice Address - Phone:262-965-2131
Practice Address - Fax:262-965-4107
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI136180202084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32181300Medicaid
WI13618020OtherWIS REG LICENSING
WI13618020OtherWIS REG LICENSING