Healthcare Provider Details

I. General information

NPI: 1699757302
Provider Name (Legal Business Name): ANDERSON & SHAPIRO EYE SURGEONS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 JOHN Q HAMMONS DR STE 100
MADISON WI
53717-1967
US

IV. Provider business mailing address

1200 JOHN Q HAMMONS DR STE 100
MADISON WI
53717-1967
US

V. Phone/Fax

Practice location:
  • Phone: 608-827-7705
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BOYD BALDOCK
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-234-5954