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Individual
DR. KENNETH ALAN ICZKOWSKI
Active
Individual
DR. KENNETH ALAN ICZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
065446-L
PA
207ZP0101X
Anatomic Pathology Physician
097071
OH
207ZP0101X
Anatomic Pathology Physician
24404
WV
207ZP0101X
Anatomic Pathology Physician
45517
CO
207ZP0101X
Anatomic Pathology Physician
Primary
60981
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699702373
—
WI
05
—
93707240
—
CO
Enumeration date
06/27/2006
Last updated
11/14/2013
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