MEDICARE: DR. TODD D PROCHNOW DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	OS13537	FL
2	207X00000X	Orthopaedic Surgery Physician	TP013084	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932103983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD D PROCHNOW DO

Provider Business Mailing Address
First Line	:	8333 N DAVIS HWY
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6050
Country	:	US
Telephone Number	:	850-474-8300
Fax Number	:	850-474-8654

Provider Business Practice Location Address
First Line	:	8333 N DAVIS HWY
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6050
Country	:	US
Telephone Number	:	850-474-8300
Fax Number	:	504-748-6548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/18/2023

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Directions to “ DR. TODD D PROCHNOW DO” Practice Location

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