Kovalczyk, William
Kovalczyk, William is an sole proprietor health care provider with primary practice located at 148 Mission Oak Dr , Grayson GA 30017-4153. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Kovalczyk, William can be contacted via phone (678) 376-5714.Contact Information
Primary practice address
148 Mission Oak Dr
Grayson GA 30017-4153
Phone: (678) 376-5714
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 684 | Georgia |
Profile Details
| NPI number | 1174504872 |
|---|---|
| LBN Legal business name | Kovalczyk, William |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Feb 7th, 2011 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174504872 | NPPES |
| Georgia | MEDICAID | 00521474A |
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