Kotlarz, Jack Peter

Kotlarz, Jack Peter is an sole proprietor health care provider with primary practice located at 6100 North Davis Hwy , Pensacola FL 32504-6950. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kotlarz, Jack Peter can be contacted via phone (850) 471-2377.

Contact Information

Primary practice address
6100 North Davis Hwy Pensacola FL 32504-6950
Phone: (850) 471-2377
Fax: (850) 471-9975
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME62757 Florida

Profile Details

NPI number 1922090646
LBN Legal business name Kotlarz, Jack Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Oct 22nd, 2011 - about 15 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 1922090646 NPPES
Alabama Other 590 51780 BCBS OF ALA
Alabama Other 4314144 BCBS OF ALA
Alabama Other 7618346003 BCBS OF ALA
Alabama Other 009900475 BCBS OF ALA
Alabama Other 42544 BCBS OF ALA
Alabama Other 040016528 BCBS OF ALA
Alabama MEDICAID 253548300 BCBS OF ALA

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