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General NPI Number Information
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NPI Number | 1982302857
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Entity Type | Individual
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Provider Name | MAXWELL MCCABE IRONS
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Gender | Male
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Dates
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Enumeration Date | 02/21/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 206 N MILL ST.
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City | LA FARGE
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State | WI
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Zip | 54639
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Country | US
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Telephone | 608-625-2494
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Fax |
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Provider Business Mailing Address
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Address Line | 507 S MAIN ST
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City | VIROQUA
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State | WI
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Zip | 54665-2059
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Country | US
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Telephone | 608-637-4769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 746023
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License Number State | WI
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