Individual
JONATHAN TICKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 WEST AVE S, LA CROSSE, WI 54601
(608) 785-0940
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(608) 785-0940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61177
WI
207R00000X
Internal Medicine Physician
ME105784
FL
207RH0003X
Hematology & Oncology Physician
Primary
61177
WI
Other
Enumeration date
10/01/2008
Last updated
10/27/2021
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