Provider Demographics
NPI:1396796074
Name:SOKOVICH, RONALD SCOTT (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:SCOTT
Last Name:SOKOVICH
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:123 HOSPITAL DR STE 2006
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-3320
Mailing Address - Country:US
Mailing Address - Phone:920-261-1334
Mailing Address - Fax:920-261-8755
Practice Address - Street 1:123 HOSPITAL DR STE 2006
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-3320
Practice Address - Country:US
Practice Address - Phone:920-261-1334
Practice Address - Fax:920-261-8755
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32955-020208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31930100Medicaid
WI553251OtherDEAN HEALTH PLAN
WI1023956OtherPHYSCIANS PLUS
WI340015746OtherRAILROAD MEDICARE
WI340015746OtherRAILROAD MEDICARE
WIE68712Medicare UPIN