Provider Demographics
NPI:1659320422
Name:ANDERSON, SCOTT ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALLEN
Last Name:ANDERSON
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:UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS
Mailing Address - Street 2:600 HIGHLAND AVE. ROOM H4/831-8320
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-3284
Mailing Address - Country:US
Mailing Address - Phone:608-263-0572
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS
Practice Address - Street 2:600 HIGHLAND AVE. ROOM H4/831-8320
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-3284
Practice Address - Country:US
Practice Address - Phone:608-263-0572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV49520390200000X
WI1537207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program