Healthcare Provider Details

I. General information

NPI: 1396993788
Provider Name (Legal Business Name): ARUNA V JOSYULA MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 12/02/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E CAMPUS MALL RM 5151
MADISON WI
53715-1365
US

IV. Provider business mailing address

333 E CAMPUS MALL RM 5151
MADISON WI
53715-1365
US

V. Phone/Fax

Practice location:
  • Phone: 608-265-5600
  • Fax:
Mailing address:
  • Phone: 608-890-1696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2011-01977
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7644220
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number4301106169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: