Doctor Name: | TYLER M PROUT |
NPI Number: | 1003864125 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 48471 |
Business Practice Address: | 600 Highland Ave Madison, WI - 537920001 |
Business Phone Number: | 6082638340 |
Business Fax Number: | 6082656533 |
Mailing Address: | 7974 Uw Health Ct, MIDDLETON |
State: | WI |
Postal Code: | 535625531 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/04/2006 |
NPI Last Update Date: | 05/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 48471 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |