Individual
DR. WAYNE ROBERT KOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5320 S 1950 W, ROY, UT 84067-2402
(801) 773-6565
(801) 774-6967
Mailing address
5320 S 1950 W, ROY, UT 84067-2402
(801) 773-6565
(801) 774-6967
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0511
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480157299
RAILROAD MEDICARE
UT
Enumeration date
06/14/2005
Last updated
10/06/2008
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