Fossum, Jane E

Fossum, Jane E is an individual health care provider with primary practice located at 1905 Huebbe Pkwy , Beloit WI 53511-1842. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Fossum, Jane E can be contacted via phone (608) 364-2293.

Contact Information

Primary practice address
1905 Huebbe Pkwy Beloit WI 53511-1842
Phone: (608) 364-2293
Fax: (608) 364-2700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 20990020 Wisconsin

Profile Details

NPI number 1902814932
LBN Legal business name Fossum, Jane E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Aug 21st, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902814932 NPPES
Other 10637 DEAN HEALTH PLAN HMO
MEDICAID 30105800 DEAN HEALTH PLAN HMO

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