Provider Demographics
NPI:1669868709
Name:BABCHENKO, OKSANA O (MD)
Entity type:Individual
Prefix:
First Name:OKSANA
Middle Name:O
Last Name:BABCHENKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 DEMING WAY STE 240
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5527
Mailing Address - Country:US
Mailing Address - Phone:608-821-4000
Mailing Address - Fax:608-821-4040
Practice Address - Street 1:2275 DEMING WAY STE 240
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-5527
Practice Address - Country:US
Practice Address - Phone:608-821-4000
Practice Address - Fax:608-821-4040
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5783-8512086S0122X
WI675582086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1669868709Medicaid