Gregory Harley, PA is a
Physician Assistant based in Wild Rose, Wisconsin. Gregory Harley is licensed to practice in Wisconsin (license number 585-023) and his current practice location is
701 Grove Ave, Wild Rose, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(920) 622-5560.
NPI number for Gregory Harley is 1619962644 and his current mailing address is 701 Grove Ave, Wild Rose, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619962644.
Provider's Profile
| Full Name | Gregory Harley |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
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| Location | 701 Grove Ave, Wild Rose, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1619962644
- Provider Enumeration Date: 09/15/2005
- Last Update Date: 04/29/2014
Medical Identifiers
Medical identifiers for Gregory Harley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619962644 | NPI | - | NPPES |
| 42924200 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 585-023 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gregory Harley is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Gregory Harley, PA
701 Grove Ave,
Wild Rose, WI 54984-6901
Ph: (920) 622-5560 | Gregory Harley, PA
701 Grove Ave,
Wild Rose, WI 54984-6901
Ph: (920) 622-5560 |
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