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General NPI Number Information
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NPI Number | 1396796074
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Entity Type | Individual
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Provider Name | RONALD SCOTT SOKOVICH M.D., F.A.C.S.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 123 HOSPITAL DR STE 2006
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City | WATERTOWN
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State | WI
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Zip | 53098-3320
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Country | US
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Telephone | 920-261-1334
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Fax | 920-261-8755
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Provider Business Mailing Address
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Address Line | 123 HOSPITAL DR STE 2006
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City | WATERTOWN
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State | WI
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Zip | 53098-3320
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Country | US
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Telephone | 920-261-1334
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Fax | 920-261-8755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 32955-020
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License Number State | WI
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