Healthcare Provider Details

I. General information

NPI: 1790002913
Provider Name (Legal Business Name): BRADLEY ARTHUR SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 04/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UW HOSPITAL AND CLINICS 600 HIGHLAND AVE
MADISON WI
53792-0001
US

IV. Provider business mailing address

UW HOSPITAL AND CLINICS 600 HIGHLAND AVE
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-6400
  • Fax:
Mailing address:
  • Phone: 608-263-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number65869 - 20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number26168
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number65869
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: