Provider Demographics
NPI:1710216205
Name:UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Entity Type:Organization
Organization Name:UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Other - Org Name:ORTHOTICS AND PROSTHETICS CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-263-7013
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:COMPLIANCE MC 2433
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-1539
Mailing Address - Country:US
Mailing Address - Phone:608-662-0817
Mailing Address - Fax:
Practice Address - Street 1:6220 UNIVERSITY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3481
Practice Address - Country:US
Practice Address - Phone:608-263-0583
Practice Address - Fax:608-262-8539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-14
Last Update Date:2022-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies