Organization
SBH-MADISON LLC
Active
Other names
Miramont Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GILBERT (CHIEF LEGAL OFFICER)
(615) 716-4924
Entity
Organization
Contact information
Practice address
3169 DEMING WAY, MIDDLETON, WI 53562-1435
(608) 716-8288
Mailing address
3169 DEMING WAY, MIDDLETON, WI 53562-1435
(608) 690-6880
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100192621
—
WI
Enumeration date
03/02/2022
Last updated
10/29/2025
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