Healthcare Provider Details
I. General information
NPI: 1003946195
Provider Name (Legal Business Name): MEDICAL ART PROSTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7818 BIG SKY DR STE 111
MADISON WI
53719-4983
US
IV. Provider business mailing address
7818 BIG SKY DR STE 111
MADISON WI
53719-4983
US
V. Phone/Fax
- Phone: 608-833-7002
- Fax: 608-893-6404
- Phone: 608-833-7002
- Fax: 608-893-6404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 229N00000X |
| Taxonomy | Anaplastologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GREGORY
G
GION
Title or Position: ANAPLASTOLOGIST/PROSTHETIST/OWNER
Credential: CCA, BOCP
Phone: 608-833-7002