Healthcare Provider Details

I. General information

NPI: 1619923406
Provider Name (Legal Business Name): JAMES W SEHLOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 TUTTLE ST
BARABOO WI
53913-1501
US

IV. Provider business mailing address

1626 TUTTLE ST
BARABOO WI
53913-1501
US

V. Phone/Fax

Practice location:
  • Phone: 608-355-2033
  • Fax: 608-355-6820
Mailing address:
  • Phone: 608-355-2033
  • Fax: 608-355-6820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number24753-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: