Most Relevant Information
Provider Data
| NPI Number: | 1003557059 |
| Provider Name: | JACOB ALEXANDER BETHEL MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/05/2022 |
| Last Updated: | 05/07/2022 |
Provider Practice Location
749 UNIVERSITY ROW STE 200
MADISON
WI
537051465
Practice Location Phone/Fax
| Phone: | 6082636400 |
| Fax: |
Provider Mailing Location
749 UNIVERSITY ROW STE 200
MADISON
WI
537051465
Provider Mailing Phone/Fax
| Phone: | 6082636400 |
| Fax: |