Individual
IGNACIO AGUSTIN DE CICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 274-8370
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-43226
KS
Other
Enumeration date
06/25/2014
Last updated
07/02/2020
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