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Individual
JACK PETER KOTLARZ
Active
Individual
JACK PETER KOTLARZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME62757
FL
207Y00000X
Otolaryngology Physician
2024013411
MO
207Y00000X
Otolaryngology Physician
ME62757
FL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
036170362
IL
Other
Enumeration date
08/18/2005
Last updated
12/10/2024
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