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General NPI Number Information
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NPI Number | 1134271992
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Entity Type | Organization
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Legal Business Name | PLATTEVILLE PODIATRY, LLC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 915 E MINERAL ST
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City | PLATTEVILLE
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State | WI
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Zip | 53818-2920
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Country | US
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Telephone | 608-348-7688
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Fax | 608-348-7687
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Provider Business Mailing Address
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Address Line | 915 E MINERAL ST
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City | PLATTEVILLE
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State | WI
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Zip | 53818-2920
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Country | US
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Telephone | 608-348-7688
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Fax | 608-348-7687
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SCOTT H KJAR
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Credential | DPM
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Telephone | 608-348-7688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | WI 662
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License Number State | WI
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