Individual
TERRY LEE MOOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-8100
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 263-8100
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
11210
GA
367H00000X
Anesthesiologist Assistant
Primary
627
WI
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
09/13/2022
Last updated
07/03/2026
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