# DR. MICHAEL CLARKSTON SOULT II

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1700014289
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 036140186 | IL | — |
| 2086S0129X | Vascular Surgery Physician | 036.140186 | IL | — |
| 2086S0129X | Vascular Surgery Physician | 036140186 | IL | Yes |

## Other

- **Enumeration date:** 06/23/2009
- **Last updated:** 03/31/2025