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General NPI Number Information
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NPI Number | 1679570774
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Entity Type | Organization
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Legal Business Name | NOVAMED SURGERY CENTER OF MADISON, LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 1200 JOHN Q HAMMONS DR SUITE 102
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City | MADISON
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State | WI
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Zip | 53717-1959
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Country | US
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Telephone | 608-827-5504
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Fax | 608-827-6107
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Provider Business Mailing Address
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Address Line | 1200 JOHN Q HAMMONS DR SUITE 102
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City | MADISON
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State | WI
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Zip | 53717-1959
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Country | US
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Telephone | 608-827-5504
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Fax |
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | WI
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