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Contact Information

DAVID SURPRENANT
120 SE 4TH ST
EVANSVILLE, IN47708-1607
 Phone: 812-463-4306
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for DAVID SURPRENANT · (Male)

NPI Number 1265895932
Status Active
Credentials
Entity Individual
Enumeration date 03/31/2016
Last updated 10/08/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 125070659
  • IN License # 01085760A
  • OH License # 35138872
Hospital affiliation(s)
  • DEACONESS HOSPITAL INC - (Acute Care)
    600 MARY ST
    EVANSVILLE, IN 47747
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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