Individual
TIMOTHY P VANDERBILT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 288-6495
Mailing address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 288-6495
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
102696
AK
207X00000X
Orthopaedic Surgery Physician
17227
NV
207X00000X
Orthopaedic Surgery Physician
55868-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548403231
—
WI
Enumeration date
04/11/2009
Last updated
01/31/2022
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