Kisicki, Daniel Ryan

Kisicki, Daniel Ryan is an sole proprietor health care provider with primary practice located at 4017 Rawlins St , Cheyenne WY 82001-1800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Kisicki, Daniel Ryan can be contacted via phone (307) 635-2562.

Contact Information

Primary practice address
4017 Rawlins St Cheyenne WY 82001-1800
Phone: (307) 635-2562
Fax: (307) 638-2074
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301092823 Michigan
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 9010A Wyoming
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 9010A Wyoming

Profile Details

NPI number 1902060833
LBN Legal business name Kisicki, Daniel Ryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 10th, 2008
Last updated Oct 28th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902060833 NPPES
Wyoming MEDICAID 1902060833

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