Provider Demographics
NPI:1316070659
Name:MADISON BIRTH CENTER
Entity type:Organization
Organization Name:MADISON BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASZANI
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNKLER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, MSN
Authorized Official - Phone:608-821-0123
Mailing Address - Street 1:6720 FRANK LLOYD WRIGHT AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-1753
Mailing Address - Country:US
Mailing Address - Phone:608-821-0123
Mailing Address - Fax:608-821-0124
Practice Address - Street 1:6720 FRANK LLOYD WRIGHT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-1753
Practice Address - Country:US
Practice Address - Phone:608-821-0123
Practice Address - Fax:608-821-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty