Individual
MR. JAMIE RUSSELL BIRKELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 S PARK ST, MADISON, WI 53715-1375
(608) 287-2700
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085003567
IL
363A00000X
Physician Assistant
12013
MN
363A00000X
Physician Assistant
Primary
7847-23
WI
Other
Enumeration date
05/04/2007
Last updated
06/07/2024
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