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NPI Code Detail

MEDICARE: COLE THEISEN DO

MEDICARE: COLE THEISEN DO
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
1390200000XStudent in an Organized Health Care Education/Training Program102469851WI

General Provider Information

NPI Number : 1568250876
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLE THEISEN DO
Provider Business Mailing Address
First Line : 749 UNIVERSITY ROW STE 200
Second Line :
City : MADISON
State : WI
Zip : 53705-1465
Country : US
Telephone Number : 608-263-6400
Fax Number :
Provider Business Practice Location Address
First Line : 749 UNIVERSITY ROW STE 200
Second Line :
City : MADISON
State : WI
Zip : 53705-1465
Country : US
Telephone Number : 608-263-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2025
Last Update Date : 06/13/2026

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Directions to “ COLE THEISEN DO” Practice Location

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