Healthcare Provider Details

I. General information

NPI: 1124282017
Provider Name (Legal Business Name): ROBERT SCOTT SOULIER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BRYANT WILLIAMS DR STE 1
KLAMATH FALLS OR
97601-1121
US

IV. Provider business mailing address

2865 DAGGETT AVE
KLAMATH FALLS OR
97601-1106
US

V. Phone/Fax

Practice location:
  • Phone: 541-884-7746
  • Fax: 541-274-5705
Mailing address:
  • Phone: 541-274-6221
  • Fax: 541-274-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDP223154
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: