Healthcare Provider Details

I. General information

NPI: 1861837981
Provider Name (Legal Business Name): JAMES PATRICK LIPPOLD HEARING AID SPEC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 E WASHINGTON AVE
MADISON WI
53704-5206
US

IV. Provider business mailing address

2040 E WASHINGTON AVE
MADISON WI
53704-5206
US

V. Phone/Fax

Practice location:
  • Phone: 608-249-4077
  • Fax:
Mailing address:
  • Phone: 608-249-4077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1328060
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1328-060
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: