Provider Demographics
NPI:1154303303
Name:JANQUART, NEAL JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:JOSEPH
Last Name:JANQUART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 REGENT ST
Mailing Address - Street 2:DAVIS DUEHR DEAN MEDICAL CENTER
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1248
Mailing Address - Country:US
Mailing Address - Phone:608-282-2000
Mailing Address - Fax:608-282-2068
Practice Address - Street 1:1025 REGENT ST
Practice Address - Street 2:DAVIS DUEHR DEAN MEDICAL CENTER
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1248
Practice Address - Country:US
Practice Address - Phone:608-282-2000
Practice Address - Fax:608-282-2068
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43852-020207L00000X
OH35084280J207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1154303303Medicaid
WI60820OtherDEAN HEALTH INSURANCE
KY64088461Medicaid
000000331835OtherANTHEM BLUE SHIELD
OH2487250Medicaid
7340619OtherAETNA
IN200484850Medicaid
300067305OtherTAX ID
300067305OtherTAX ID
OHJA4132141Medicare ID - Type Unspecified
KY64088461Medicaid
WI60820OtherDEAN HEALTH INSURANCE