Kostick, David A

Kostick, David A is an individual health care provider with primary practice located at 11512 Lake Mead Ave Unit 534, Jacksonville FL 32256-9680. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Kostick, David A can be contacted via phone (904) 642-2222.

Contact Information

Primary practice address
11512 Lake Mead Ave Unit 534 Jacksonville FL 32256-9680
Phone: (904) 642-2222
Fax: (904) 683-3934
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME68360 Florida

Profile Details

NPI number 1336139187
LBN Legal business name Kostick, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Dec 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336139187 NPPES
Georgia MEDICAID 000685836A
Georgia MEDICAID 377942400
Georgia Other 180022583
Georgia Other 27478

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