Provider Demographics
NPI:1952362329
Name:LANS, JOEL ISIDORE (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ISIDORE
Last Name:LANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9302 HIGHLAND GATE WAY
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-8200
Mailing Address - Country:US
Mailing Address - Phone:262-844-5880
Mailing Address - Fax:
Practice Address - Street 1:9302 HIGHLAND GATE WAY
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-8200
Practice Address - Country:US
Practice Address - Phone:262-844-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31062-020207RG0100X
MN78517207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31597500Medicaid
WI000468085Medicare PIN
WI100013073Medicare PIN
WI31597500Medicaid