Provider Demographics
NPI:1760596597
Name:PUTNEY, MICHAEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:PUTNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16020 PARK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3573
Mailing Address - Country:US
Mailing Address - Phone:512-244-0766
Mailing Address - Fax:
Practice Address - Street 1:1301 MEDICAL PKWY STE 140
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2529
Practice Address - Country:US
Practice Address - Phone:512-379-3660
Practice Address - Fax:512-379-3661
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0740207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H15920Medicare UPIN
8593M1Medicare ID - Type Unspecified