Basic Information
| Provider Information | |||||||||
| NPI: | 1649239898 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEGAL | ||||||||
| FirstName: | IRA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1265 JOHN Q HAMMONS DR | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537171921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082229777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5249 E TERRACE DR | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537188339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082229777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2006 | ||||||||
| LastUpdateDate: | 02/26/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 53999 | WI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.