Iczkowski, Kenneth Alan
Iczkowski, Kenneth Alan is an individual health care provider with primary practice located at 9200 W Wisconsin Ave Department Of Pathology, Milwaukee WI 53226-3522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Iczkowski, Kenneth Alan can be contacted via phone (414) 805-6966.Contact Information
Primary practice address
9200 W Wisconsin Ave Department Of Pathology
Milwaukee WI 53226-3522
Phone: (414) 805-6966
Fax: (414) 805-6980
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 45517 | Colorado |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 097071 | Ohio |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 24404 | West Virginia |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 065446-L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 60981 | Wisconsin |
Profile Details
| NPI number | 1699702373 |
|---|---|
| LBN Legal business name | Iczkowski, Kenneth Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Nov 14th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699702373 | NPPES |
| Colorado | MEDICAID | 93707240 | |
| Colorado | MEDICAID | 1699702373 |
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