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NPI Code Detail

MEDICARE: DR. ADAM HAMISI KIBOLA MD

MEDICARE: DR. ADAM HAMISI KIBOLA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician66945WI
2208M00000XHospitalist Physician66945WI

General Provider Information

NPI Number : 1366861445
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADAM HAMISI KIBOLA MD
Provider Business Mailing Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-387-5511
Fax Number :
Provider Business Practice Location Address
First Line : 1700 W STOUT ST
Second Line :
City : RICE LAKE
State : WI
Zip : 54868-5000
Country : US
Telephone Number : 715-236-6380
Fax Number : 715-236-6422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 04/20/2026

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