MEDICARE: DR. MOLLIE L. KANE 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
1	208000000X	Pediatrics Physician	45307-20	WI

General Provider Information

NPI Number	:	1427013069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOLLIE L. KANE MD

Provider Business Mailing Address
First Line	:	2228 HILLINGTON GRN
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53726-5308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2228 HILLINGTON GRN
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53726-5308
Country	:	US
Telephone Number	:	608-215-3575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	06/23/2022

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