Healthcare Provider Details

I. General information

NPI: 1083057020
Provider Name (Legal Business Name): JOHN TRUITT DOLLERSCHELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 EDGEHILL DR
MADISON WI
53705-1410
US

IV. Provider business mailing address

1007 EDGEHILL DR
MADISON WI
53705-1410
US

V. Phone/Fax

Practice location:
  • Phone: 913-909-1759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number74786-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number74786-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: