Individual
PATRICIA KOTYLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
411 S OAKWOOD DR, GREENWOOD, IN 46142-2047
(317) 889-8452
Mailing address
411 S OAKWOOD DR, GREENWOOD, IN 46142-2047
(317) 889-8452
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38760
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085801
ANTHEM PROVIDER NUMBER
IN
05
—
100360620
—
IN
Enumeration date
05/31/2005
Last updated
04/24/2018
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