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General NPI Number Information
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NPI Number | 1285963405
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Entity Type | Organization
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Legal Business Name | WILLIAM LYTKOWSKI,D.O., P.C.
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 12/17/2009
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Provider Practice Location Address
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Address Line | 1103 WALNUT DR
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City | ARDMORE
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State | OK
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Zip | 73401-2354
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Country | US
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Telephone | 580-226-6290
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 WALNUT DR
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City | ARDMORE
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State | OK
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Zip | 73401
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Country | US
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Telephone | 580-226-6290
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM LYTKOWSKI
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Credential | D.O.
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Telephone | 580-504-3999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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