Healthcare Provider Details

I. General information

NPI: 1326080672
Provider Name (Legal Business Name): TIMOTHY R MCHUGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 N HIGH POINT RD
MADISON WI
53717-2236
US

IV. Provider business mailing address

752 N HIGH POINT RD
MADISON WI
53717-2236
US

V. Phone/Fax

Practice location:
  • Phone: 608-824-4000
  • Fax: 608-824-4919
Mailing address:
  • Phone: 608-824-4000
  • Fax: 608-824-4910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number37761-020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37761-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: