Provider Demographics
NPI:1417384934
Name:SECKEL, COLE WILLIAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:WILLIAM
Last Name:SECKEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2540
Mailing Address - Country:US
Mailing Address - Phone:608-831-8555
Mailing Address - Fax:608-831-9747
Practice Address - Street 1:2241 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2540
Practice Address - Country:US
Practice Address - Phone:608-831-8555
Practice Address - Fax:608-831-9747
Is Sole Proprietor?:No
Enumeration Date:2013-09-29
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17047-40183500000X
NE14226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist