Individual
DR. JEFFREY S WALCZYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3385 DEXTER CT, SUITE 103, DAVENPORT, IA 52807-3471
(563) 441-5860
(563) 441-5865
Mailing address
3385 DEXTER CT, SUITE 103, DAVENPORT, IA 52807-3471
(563) 441-5860
(563) 441-5865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26742
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508843384
—
IA
05
—
2042432
—
IA
Enumeration date
12/22/2005
Last updated
01/15/2014
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