EDGEWOOD COLLEGE INC NPI 1740739622

NPI Information

  • NPI: 1740739622
  • Provider Name: EDGEWOOD COLLEGE, INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: EDGEWOOD COLLEGE SPORTS MEDICINE
  • Address: 1000 EDGEWOOD COLLEGE DR
    MADISON, WI
    ZIP 53711
  • Phone: (608) 663-4861

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NPI Details

EDGEWOOD COLLEGE, INC is a family medicine in Madison, WI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EDGEWOOD COLLEGE, INC NPI is 1740739622. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Edgewood College Sports Medicine.

The provider's business location address is:

1000 EDGEWOOD COLLEGE DR
MADISON, WI
ZIP 53711-997
Phone: (608) 663-4861

The provider's authorized official is Mouzon Bass .
The authorized official title is Agent and has the following contact phone number (972) 367-4845.

The enumeration date for this NPI number is 10/3/2016 and was last updated on 10/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine64261-21WISCONSINYes

What is NPI?

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This page was last updated on: 11/21/2025

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