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JERRY W HALSTEN PHD

Clinical Neuropsychologist

Madison, Wisconsin

Provider NPI: 1114984176

Provider Information:
 JERRY W HALSTEN PHD
Gender: M
Not Sole Proprietor

Practice Location:
1313 FISH HATCHERY RD DEAN MEDICAL CENTER MADISON, WI 53715 US
Tel: 608-252-8000  Fax: 608-252-8245

Business Mailing Address:
1313 FISH HATCHERY RD DEAN MEDICAL CENTER MADISON, WI 53715 US
Tel: 608-252-8000  Fax: 608-252-8245

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
WI1820-057

Other Provider Identifiers:

IssuerNumberStateType
39105900WI05
DEAN HEALTH INSURANCE7310WI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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