Individual
CHRISTOPHER DAVID TYKOCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8245 HOLLY RD, SUITE 103, GRAND BLANC, MI 48439-2443
(810) 694-2720
(810) 953-4473
Mailing address
8245 HOLLY RD, SUITE 103, GRAND BLANC, MI 48439-2443
(810) 694-2720
(810) 953-4473
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
CT012113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0980879
HEALTH PLUS
MI
05
—
4228726
—
MI
01
—
5404569
AETNA
MI
01
—
OB51658
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/23/2006
Last updated
12/26/2012
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