Jacob, Alexis Danielle

Jacob, Alexis Danielle is an individual health care provider with primary practice located at 700 S Park St Ste A , Madison WI 53715-1830. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is her primary health care specialty. Jacob, Alexis Danielle can be contacted via phone (608) 260-2900.

Contact Information

Primary practice address
700 S Park St Ste A Madison WI 53715-1830
Phone: (608) 260-2900
Fax: (608) 260-2961
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X BP10023656 Texas
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X N6891 Texas
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 77962-20 Wisconsin

Profile Details

NPI number 1881924819
LBN Legal business name Jacob, Alexis Danielle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 14th, 2010
Last updated Jun 12th, 2023 - about last year

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 1881924819 NPPES
Wisconsin MEDICAID 1881924819

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