Basic Information
Provider Information
NPI: 1265407662
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABELL
FirstName: WARREN
MiddleName: F
NamePrefix:  
NameSuffix: JR.
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 218
Address2: 2600 65TH AVENUE
City: OSCEOLA
State: WI
PostalCode: 540203024
CountryCode: US
TelephoneNumber: 7152942111
FaxNumber: 7152942111
Practice Location
Address1: 2600 65TH AVENUE
Address2:  
City: OSCEOLA
State: WI
PostalCode: 540203024
CountryCode: US
TelephoneNumber: 7152942111
FaxNumber: 7152945758
Other Information
ProviderEnumerationDate: 02/20/2006
LastUpdateDate: 10/21/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X32298MNN Allopathic & Osteopathic PhysiciansSurgery 
208600000X53721WIY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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