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Individual
JONATHAN TICKU
Active
Individual
JONATHAN TICKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61177
WI
207R00000X
Internal Medicine Physician
ME105784
FL
207RH0003X
Hematology & Oncology Physician
Primary
61177
WI
Other
Enumeration date
10/01/2008
Last updated
10/27/2021
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