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NPI Code Detail

MEDICARE: DR. ROELOF TIKKER D.P.M.

MEDICARE:  DR. ROELOF  TIKKER  D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristE882CA

General Provider Information

NPI Number : 1558361014
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROELOF TIKKER D.P.M.
Provider Business Mailing Address
First Line : 254 SILVERADO SPRINGS DR
Second Line :
City : NAPA
State : CA
Zip : 94558-1556
Country : US
Telephone Number : 707-237-2673
Fax Number : 916-914-2157
Provider Business Practice Location Address
First Line : 6 WOODLAND RD
Second Line : SUITE 104
City : SAINT HELENA
State : CA
Zip : 94574-9554
Country : US
Telephone Number : 707-237-2673
Fax Number : 916-914-2157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2005
Last Update Date : 07/09/2007

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Directions to “ DR. ROELOF TIKKER D.P.M.” Practice Location

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