Individual
DR. JACOB L BIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 GRANT ST, MILWAUKEE, WI 53213
(414) 286-8892
(414) 384-5578
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 647-6326
(414) 671-8860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42673
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34124900
—
WI
Enumeration date
08/05/2006
Last updated
03/07/2023
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