Healthcare Provider Details

I. General information

NPI: 1003870668
Provider Name (Legal Business Name): THOMAS A ZDEBLICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W BELTLINE HWY STE 601
MADISON WI
53713-2309
US

IV. Provider business mailing address

18444 N 25TH AVE STE 310
PHOENIX AZ
85023-1266
US

V. Phone/Fax

Practice location:
  • Phone: 608-234-7436
  • Fax: 866-939-2673
Mailing address:
  • Phone: 608-234-7436
  • Fax: 866-939-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number29993-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: