Provider Demographics
NPI:1770549156
Name:SEARLES, PAUL A (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:SEARLES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TOWER DR
Mailing Address - Street 2:DEAN MEDICAL CENTER
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-1239
Mailing Address - Country:US
Mailing Address - Phone:608-825-3008
Mailing Address - Fax:608-825-3794
Practice Address - Street 1:10 TOWER DR
Practice Address - Street 2:DEAN MEDICAL CENTER
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1239
Practice Address - Country:US
Practice Address - Phone:608-825-3008
Practice Address - Fax:608-825-3794
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25173-021207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30025100Medicaid
WI1025OtherDEAN HEALTH INSURANCE
WIK400136605Medicare UPIN
B56479Medicare UPIN
WI080046014Medicare PIN
WI30025100Medicaid