Provider Demographics
NPI:1235272543
Name:SOTTAK ORTHOPAEDIC & SURGICAL, INC
Entity Type:Organization
Organization Name:SOTTAK ORTHOPAEDIC & SURGICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SOTTAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-527-3800
Mailing Address - Street 1:PO BOX 755
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-0755
Mailing Address - Country:US
Mailing Address - Phone:603-527-3800
Mailing Address - Fax:
Practice Address - Street 1:14 MAPLE ST
Practice Address - Street 2:
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6580
Practice Address - Country:US
Practice Address - Phone:603-527-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30764288Medicaid
NH0911630001Medicare NSC