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NPI 1528446713

NPI 1528446713 : JONATHAN SHIH DPM : FRANKLIN, WI

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General NPI Number Information
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    NPI Number           |    1528446713
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    Entity Type          |    Individual 
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    Provider Name        |    JONATHAN SHIH DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/08/2015
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    Last Update Date     |    06/05/2024
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Provider Practice Location Address
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    Address Line         |    9200 W LOOMIS RD STE 116 
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    City                 |    FRANKLIN
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    State                |    WI
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    Zip                  |    53132
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    Country              |    US
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    Telephone            |    414-529-9232
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    Fax                  |    414-529-9292
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Provider Business Mailing Address
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    Address Line         |    PO BOX 735044 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60673-5044
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    Country              |    US
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    Telephone            |    800-326-2250
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    Fax                  |    
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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        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    1129
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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       |    1129
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    License Number State |    WI
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