Provider Demographics
NPI:1093193690
Name:PRZYBILLA, ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PRZYBILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN
Mailing Address - Street 2:1265 JOHN Q HAMMONS DR
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN
Practice Address - Street 2:675 WEST WASHINGTON AVENUE
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703
Practice Address - Country:US
Practice Address - Phone:608-257-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67926208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics