| Doctor Name: | DR. WAYNE ROBERT KOTTER |
| NPI Number: | 1154326429 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 0511 |
| Business Practice Address: | 5320 S 1950 W Roy, UT - 840672402 |
| Business Phone Number: | 8017736565 |
| Business Fax Number: | 8017746967 |
| Mailing Address: | 5320 S 1950 W, ROY |
| State: | UT |
| Postal Code: | 840672402 |
| Phone Number: | 8017736565 |
| Fax Number: | 8017746967 |
| NPI Enumeration Date: | 06/14/2005 |
| NPI Last Update Date: | 10/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 0511 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |