Individual
DR. PAUL G SPOTTSWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 656-2011
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4266
(262) 787-4026
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
27329-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30668700
—
WI
01
—
P00318136
RAIL ROAD MEDICARE
—
Enumeration date
12/02/2005
Last updated
02/15/2009
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