Individual
MATTHEW RYAN KROLIKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4 SHERIDAN SQ STE 200, KINGSPORT, TN 37660
(423) 246-7931
(423) 246-1906
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102204541
VA
207R00000X
Internal Medicine Physician
3069
TN
207RI0200X
Infectious Disease Physician
Primary
3069
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215372578
—
VA
05
—
Q025295
—
TN
Enumeration date
04/30/2013
Last updated
01/18/2024
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