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NPI Code Detail

MEDICARE: TIMOTHY M AXE DPM

MEDICARE: TIMOTHY M AXE DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist906-025WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
360436OTHERWIDEAN HEALTH INSURANCE

General Provider Information

NPI Number : 1619932621
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY M AXE DPM
Provider Business Mailing Address
First Line : 3200 E RACINE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-2343
Country : US
Telephone Number : 608-371-8000
Fax Number : 607-371-8933
Provider Business Practice Location Address
First Line : 3200 E RACINE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-2343
Country : US
Telephone Number : 608-371-8000
Fax Number : 607-371-8933
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 10/28/2020

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Directions to “ TIMOTHY M AXE DPM” Practice Location

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