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General NPI Number Information
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NPI Number | 1134304512
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Entity Type | Individual
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Provider Name | JAN RYSZKOWSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 316 COMMENTRY WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72223-4598
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Country | US
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Telephone | 501-352-7043
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Fax |
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Provider Business Mailing Address
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Address Line | 316 COMMENTRY WAY
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City | LITTLE ROCK
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State | AR
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Zip | 72223-4598
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Country | US
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Telephone | 501-352-7043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0902X
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Taxonomy Name | Nuclear Imaging & Therapy Physician
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License Number | 4301091356
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 4301091356
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207UN0903X
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Taxonomy Name | In Vivo & In Vitro Nuclear Medicine Physician
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License Number | 4301091356
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | E-5892
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License Number State | AR
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Taxonomy #5
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 4301091356
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301091356
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License Number State | MI
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