Basic Information
Provider Information
NPI: 1487127213
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROCKWOOD
FirstName: DAVID
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: W180N8085 TOWN HALL RD
Address2:  
City: MENOMONEE FALLS
State: WI
PostalCode: 530513518
CountryCode: US
TelephoneNumber: 2622511000
FaxNumber:  
Practice Location
Address1: W180N8085 TOWN HALL RD
Address2:  
City: MENOMONEE FALLS
State: WI
PostalCode: 530513518
CountryCode: US
TelephoneNumber: 2622511000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/03/2019
LastUpdateDate: 09/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X24934TNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363LA2100X12098WIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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