Basic Information
| Provider Information | |||||||||
| NPI: | 1093033920 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TALMAGE | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 SOUTH PARK STREET | ||||||||
| Address2: | 4 TOWER | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6084176676 | ||||||||
| FaxNumber: | 6084175746 | ||||||||
| Practice Location | |||||||||
| Address1: | 202 S PARK ST | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537151507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6084176676 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2010 | ||||||||
| LastUpdateDate: | 01/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | R-8831 | IA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 4301106171 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.