Organization
JOHN A ICETON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A ICETON (MEDICAL DOCTOR)
(409) 983-5178
Entity
Organization
Contact information
Practice address
2927 PARK PLAZA LN, PORT ARTHUR, TX 77642-5516
(409) 983-5178
Mailing address
2927 PARK PLAZA LN, PORT ARTHUR, TX 77642-5516
(409) 983-5178
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H6857
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0978157-01
—
TX
01
—
H6857
MEDICAL LICENSE
—
Enumeration date
02/14/2008
Last updated
03/07/2023
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