DR. DAVID KING MIKOLYZK (NPI# 1437312774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437312774 |
| Entity Type | Individual |
| Full Name | DR. DAVID KING MIKOLYZK |
| Credential | M.D. |
| Practice Address |
1650 S 41st St Manitowoc WI 54220-7316 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9203205251 |
| Practice Fax Number | 9206822006 |
| Mailing Telephone | 9204457222 |
| Mailing Fax Number | 9204457238 |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2020-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 036117670 | IL | Allopathic & Osteopathic Physicians |
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
53986 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AMERICAN BOARD OF ORTHOPAEDIC SURGERY/HAND SURGERY | ABOSMOC | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1970 S Ridge Rd, Green Bay, WI 543044125 | 9204304888 | 9204304889 |
| 744 S Webster Ave, Green Bay, WI 543013505 | 9204333500 | 9204457301 |
| Street Address |
1650 S 41ST ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-7316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548260060 | Jonathan A Snellgrove | Podiatrist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2005-07-27 |
| 1700484326 | Kora Tesarik | Physical Therapy Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-10-15 |
| 1699386367 | Nicole Sixel | Nurse Practitioner | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-08-14 |
| 1891320735 | June C Magnussen | Nurse Practitioner | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-03-11 |
| 1063062271 | Kelly Marie Liebergen | Speech-Language Pathologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2019-09-19 |
| 1235601709 | Kara Danielle Mcclone | Physician Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-12-21 |
| 1770074809 | Andrea B Zahn | Physical Therapist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-05-24 |
| 1790274454 | Maria E Lensmire | Physical Therapy Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-05-08 |
| 1053835207 | Nicole Drew | Physical Therapist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2017-07-31 |
| 1740729714 | Margaret Huebbe | Speech-Language Pathologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2017-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013938463 | James L Knavel | Orthopaedic Surgery | 352 Peller Rd, Lake Geneva, WI 53147-4543 | 2006-07-21 |
| 1902850696 | Bone & Joint Clinic S.c. | Orthopaedic Surgery | 225000 Hummingbird Rd, Ste 100, Wausau, WI 54401-6312 | 2006-05-19 |
| 1053310474 | David James Siverhus | Orthopaedic Surgery | 2500 N Mayfair Rd, Suite 670, Milwaukee, WI 53226-1409 | 2005-07-18 |
| 1922453398 | Orthopaedic Centers of Wisconsin S.c. | Orthopaedic Surgery | 3200 Westhill Dr, Suite 201, Wausau, WI 54401-4705 | 2016-05-04 |
| 1174977433 | Orthopaedic Centers of Wisconsin, S.c. | Orthopaedic Surgery | 3200 Westhill Dr Ste 201, Wausau, WI 54401-4707 | 2016-04-22 |
| 1427476969 | Michael Derek Vaughn | Orthopaedic Surgery | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2014-04-02 |
| 1104262682 | Jasmine Bauknight | Orthopaedic Surgery | 1715 Dousman St, Green Bay, WI 54303-3211 | 2013-05-10 |
| 1154664100 | Dayton M Opel | Orthopaedic Surgery | 1821 S Stoughton Rd, Madison, WI 53716-2257 | 2013-03-28 |
| 1194088567 | Kristin Tompkins Mizerik | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2012-06-20 |
| 1881919892 | David William Meister | Orthopaedic Surgery | 525 W River Woods Pkwy, Suite 230, Glendale, WI 53212-1024 | 2010-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.