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Provider Information for 1316961451

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

SCOTT MARSHALL WISOTSKY M.D.

Gender: MALE

Individual NPI: 1316961451

Calendar   Last Updated:  2013-01-30
  Certification Date: 

Details

Name Value
NPI 1316961451
Enumeration Date 2006-07-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 430 MORTON PLANT ST SUITE 301
CLEARWATER, FL 33756-3398
United States

Phone: 727-461-6026 | Fax: 727-461-7446
View Map External Link
Primary Practice Address 430 MORTON PLANT ST SUITE 301
CLEARWATER, FL 33756-3398
United States

Phone: 727-461-6026 | Fax: 727-461-7446
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 277623500
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207XS0106X - Orthopaedic Surgery Hand Surgery FL ME95108