Provider Demographics
NPI:1003318809
Name:ORIEL MEDICINE S.C.
Entity Type:Organization
Organization Name:ORIEL MEDICINE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-238-0100
Mailing Address - Street 1:5231 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-1361
Mailing Address - Country:US
Mailing Address - Phone:608-238-0100
Mailing Address - Fax:608-238-7550
Practice Address - Street 1:5231 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-1361
Practice Address - Country:US
Practice Address - Phone:608-238-0100
Practice Address - Fax:608-238-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32156700Medicaid