Individual
DR. JACEK KOTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 W KENT AVE, MISSOULA, MT 59801-6772
(406) 541-3937
(406) 541-3811
Mailing address
PO BOX 4907, MISSOULA, MT 59806-4907
(406) 541-3937
(406) 541-3811
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
49655
MT
207WX0107X
Retina Specialist (Ophthalmology) Physician
49655
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134451487
—
MT
Enumeration date
02/10/2010
Last updated
08/12/2024
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