Provider Demographics
NPI:1114212123
Name:DOUBLEDAY, AMANDA RAE (DO, MBA)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:RAE
Last Name:DOUBLEDAY
Suffix:
Gender:F
Credentials:DO, MBA
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-1971
Practice Address - Country:US
Practice Address - Phone:608-263-7502
Practice Address - Fax:608-263-7652
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI68958208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery