Healthcare Provider Details

I. General information

NPI: 1699858811
Provider Name (Legal Business Name): THOMAS JOSEPH TRANNEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 11TH ST S
LA CROSSE WI
54601-4116
US

IV. Provider business mailing address

700 WEST AVE S PHYSICIAN SERVICES
LA CROSSE WI
54601-4783
US

V. Phone/Fax

Practice location:
  • Phone: 608-392-9555
  • Fax: 608-392-9432
Mailing address:
  • Phone: 608-392-4156
  • Fax: 608-392-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number37852
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number37852
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: