Individual
REBECCA I KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
345 W WASHINGTON AVE STE 100, MADISON, WI 53703-2996
(608) 417-8300
(608) 417-8301
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
(608) 417-3878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49401-020
WI
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
49401-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992894372
—
WI
Enumeration date
10/12/2006
Last updated
05/01/2026
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