Provider Demographics
NPI:1558552166
Name:BRIDSON, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:BRIDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 KINSMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2526
Mailing Address - Country:US
Mailing Address - Phone:608-443-1405
Mailing Address - Fax:608-661-8169
Practice Address - Street 1:3402 KINSMAN BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2526
Practice Address - Country:US
Practice Address - Phone:608-443-1405
Practice Address - Fax:608-661-8169
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17981-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine