Individual
BRENDON KYLE LUVISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 FOURIER DR STE 102, MADISON, WI 53717-2176
(608) 903-9253
Mailing address
1255 FOURIER DR STE 102, MADISON, WI 53717-2176
(608) 903-9253
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
86380-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
01/27/2026
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