Individual
DR. KATHY J RUSSETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
345 W WASHINGTON AVE STE 307, MADISON, WI 53703-6019
(414) 395-5435
Mailing address
345 W WASHINGTON AVE STE 307, MADISON, WI 53703-6019
(608) 305-4150
(608) 305-8736
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
49950-020
WI
208D00000X
General Practice Physician
49950-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275692030
MEDICARE/MEDICAID FOR GENERAL PRACTICE SERVICES
WI
Enumeration date
12/07/2006
Last updated
10/04/2024
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