Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 61494-20 | WI |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 61494-20 | WI |
NPI | 1508295841 |
---|---|
Provider Name | Chris K Rokkas |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-3522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2013 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508295841 | (05) | WI |