Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 35.133907 | OH |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 74594-20 | WI |
NPI | 1053653386 |
---|---|
Provider Name | Mr. Oliver James Scotting |
First Address | Menomonee Falls, WI 53051-2301 |
Second Address | Menomonee Falls, WI 53051-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 22/02/2021 |