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General NPI Number Information
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NPI Number | 1265574933
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Entity Type | Organization
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Legal Business Name | PLAZA PODIATRY ASSOCIATES LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 140 WILSHIRE BLVD N
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City | STEVENS POINT
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State | WI
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Zip | 54481-1360
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Country | US
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Telephone | 715-341-1266
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Fax | 715-341-1268
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Provider Business Mailing Address
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Address Line | 140 WILSHIRE BLVD N
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City | STEVENS POINT
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State | WI
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Zip | 54481-1360
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Country | US
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Telephone | 715-341-1266
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Fax | 715-341-1268
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM BRIAN QUINN
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Credential | DPM
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Telephone | 715-341-1266
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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 | 896025
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 497025
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License Number State | WI
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