Healthcare Provider Details

I. General information

NPI: 1962965129
Provider Name (Legal Business Name): KARLEY MECKO SCOLES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 HEIGHTS DR STE 2D
EAU CLAIRE WI
54701-6146
US

IV. Provider business mailing address

2125 HEIGHTS DR STE 2D
EAU CLAIRE WI
54701-6146
US

V. Phone/Fax

Practice location:
  • Phone: 715-204-9279
  • Fax: 715-504-8945
Mailing address:
  • Phone: 715-204-9279
  • Fax: 715-504-8945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number73836
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: