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General NPI Number Information
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NPI Number | 1265498778
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Entity Type | Individual
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Provider Name | DEBASISH BHATTACHARYYA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 800 CLAY ST
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City | DARLINGTON
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State | WI
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Zip | 53530-1228
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Country | US
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Telephone | 608-776-5748
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Fax | 608-776-5719
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Provider Business Mailing Address
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Address Line | 800 CLAY ST
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City | DARLINGTON
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State | WI
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Zip | 53530-1228
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Country | US
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Telephone | 608-776-4466
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Fax | 608-776-5716
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35.087860
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036-139526
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 036-139526
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 52689-20
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 52689-20
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License Number State | WI
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