Scattergood, Kirk D

Scattergood, Kirk D is an individual health care provider with primary practice located at 2253 W Mason St Ste 100 , Green Bay WI 54303-4706. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Scattergood, Kirk D can be contacted via phone (920) 327-7000.

Contact Information

Primary practice address
2253 W Mason St Ste 100 Green Bay WI 54303-4706
Phone: (920) 327-7000
Fax: (920) 327-7005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 36086 Wisconsin
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 36086 Wisconsin

Profile Details

NPI number 1790702652
LBN Legal business name Scattergood, Kirk D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Jun 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790702652 NPPES
Wisconsin MEDICAID 32078200

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