Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 17315 | WI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 17315 | WI |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 17315 | WI |
NPI | 1831131390 |
---|---|
Provider Name | Edmund Lawrence Markey JR. |
First Address | Wausau, WI 54401-4123 |
Second Address | Wausau, WI 54401-4123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 06/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30201000 | (05) | WI |
AM9039264 | DRUG ENFORCEMENT ADMIN (01) | |
D80080 | (02) | WI |