Healthcare Provider Details

I. General information

NPI: 1144296617
Provider Name (Legal Business Name): RICHARD E APPEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 UNIVERSITY AVE
MADISON WI
53705
US

IV. Provider business mailing address

8007 EXCELSIOR DR
MADISON WI
53717
US

V. Phone/Fax

Practice location:
  • Phone: 608-756-7147
  • Fax:
Mailing address:
  • Phone: 608-829-5247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number16776
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: