MEDICARE: LAUREL D RABSON 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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	34553-20	WI
2	207Q00000X	Family Medicine Physician	34553-20	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4749	OTHER	WI	DEAN HEALTH INSURANCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609821867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREL D RABSON MD

Provider Business Mailing Address
First Line	:	1324 VILAS AVE
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-1552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 S PARK ST STE 100
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53715-1708
Country	:	US
Telephone Number	:	608-263-3111
Fax Number	:	608-263-6663

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	04/15/2022

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