Individual
DR. THEODORE L KITOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
708 N 18TH ST, MARYSVILLE, KS 66508-1338
(785) 562-2311
(785) 562-2348
Mailing address
708 N 18TH ST, MARYSVILLE, KS 66508-1338
(785) 562-2311
(785) 562-2348
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
420460
KS
2085U0001X
Diagnostic Ultrasound Physician
420460
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047203
BC/BS
KS
01
—
608180
FIRST GUARD
KS
Enumeration date
07/15/2006
Last updated
09/27/2007
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