Basic Information
| Provider Information | |||||||||
| NPI: | 1073801205 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOKN | ||||||||
| FirstName: | ERICK | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 HIGHLAND AVE | ||||||||
| Address2: | MC 2433 | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537921530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6086620817 | ||||||||
| FaxNumber: | 6082034544 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 HIGHLAND AVE | ||||||||
| Address2: | MC 2433 | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537921530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6086620817 | ||||||||
| FaxNumber: | 6082034544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2011 | ||||||||
| LastUpdateDate: | 07/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 16335-40 | WI | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.