Provider Demographics
NPI:1164660015
Name:SOHL, ANDREW J (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:SOHL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 BUCK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1741
Mailing Address - Country:US
Mailing Address - Phone:267-699-3839
Mailing Address - Fax:267-699-3906
Practice Address - Street 1:86 BUCK RD STE 2
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966
Practice Address - Country:US
Practice Address - Phone:267-699-3839
Practice Address - Fax:267-699-3906
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006083213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026153020001Medicaid
PA1026153020001Medicaid