Healthcare Provider Details

I. General information

NPI: 1285624973
Provider Name (Legal Business Name): BONE & JOINT SURGERY ASSOCIATES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S WHITNEY WAY
MADISON WI
53705-4656
US

IV. Provider business mailing address

340 S WHITNEY WAY
MADISON WI
53705-4656
US

V. Phone/Fax

Practice location:
  • Phone: 608-238-9311
  • Fax: 608-238-8810
Mailing address:
  • Phone: 608-238-9311
  • Fax: 608-238-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number21380
License Number StateWI

VIII. Authorized Official

Name: DR. DAVID H BARTLETT
Title or Position: PRESIDENT
Credential: MD
Phone: 608-238-9311