Provider Demographics
NPI:1760554091
Name:NOTT, ERIK V (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:V
Last Name:NOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MDG
Mailing Address - Street 2:4881 SUGAR MAPLE DR
Mailing Address - City:WPAFB
Mailing Address - State:OH
Mailing Address - Zip Code:45433
Mailing Address - Country:US
Mailing Address - Phone:937-257-9517
Mailing Address - Fax:
Practice Address - Street 1:88 MDG
Practice Address - Street 2:4881 SUGAR MAPLE DR
Practice Address - City:WPAFB
Practice Address - State:OH
Practice Address - Zip Code:45433
Practice Address - Country:US
Practice Address - Phone:937-257-9517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010031657207X00000X
CO54603207X00000X
OH35.144533.MIL207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery