Edgewood College, INC

NPI #1740739622 in Madison, Wisconsin

Provider Information

NPI Number: 1740739622
Entity Type: Organization
Organization Name: Edgewood College, INC
Primary Specialty: Family Medicine
Enumeration Date: Oct 3, 2016
Last Updated: Oct 3, 2016

Practice Location

Address: 1000 EDGEWOOD COLLEGE DR
City: Madison
State: Wisconsin
ZIP Code: 53711-1997
Phone: (608) 663-4861

Authorized Official

Name: MOUZON BASS
Title: AGENT
Phone: (972) 367-4845

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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