Healthcare Provider Details

I. General information

NPI: 1083241566
Provider Name (Legal Business Name): AUSTIN HUGH MIDDLETON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 W RIVER WOODS PKWY
GLENDALE WI
53212-1024
US

IV. Provider business mailing address

525 W RIVER WOODS PKWY STE 130
GLENDALE WI
53212-1010
US

V. Phone/Fax

Practice location:
  • Phone: 414-961-0304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number75993-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: