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NPI Code Detail

MEDICARE: SCOTT LIEGEL

MEDICARE: SCOTT LIEGEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant8363WI

General Provider Information

NPI Number : 1023580776
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT LIEGEL
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4602 EASTPARK BLVD
Second Line :
City : MADISON
State : WI
Zip : 53718-2002
Country : US
Telephone Number : 608-263-7540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2018
Last Update Date : 04/09/2026

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Directions to “ SCOTT LIEGEL ” Practice Location

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