Healthcare Provider Details

I. General information

NPI: 1356206833
Provider Name (Legal Business Name): UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S PARK ST FL 4
MADISON WI
53715-1375
US

IV. Provider business mailing address

7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US

V. Phone/Fax

Practice location:
  • Phone: 608-916-0115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WAYNE FLANNERY
Title or Position: CAO & CFO UW HEALTH-UW MEDICAL FOUN
Credential:
Phone: 608-821-4223