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General NPI Number Information
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NPI Number | 1780269449
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Entity Type | Organization
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Legal Business Name | PARKINS PLASTIC SURGERY
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 685 E VALLEY RD
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City | OCONOMOWOC
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State | WI
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Zip | 53066-4766
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Country | US
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Telephone | 414-704-2155
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Fax | 262-205-1463
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Provider Business Mailing Address
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Address Line | 685 E VALLEY RD
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City | OCONOMOWOC
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State | WI
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Zip | 53066-4766
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Country | US
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Telephone | 414-704-2155
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Fax | 262-205-1463
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. DAVID G PARKINS
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Credential | M.D.
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Telephone | 414-704-2155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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