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General NPI Number Information
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NPI Number | 1790887263
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Entity Type | Organization
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Legal Business Name | JAROSLAW K PASZKOWIAK MD PC
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Dates
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Enumeration Date | 09/03/2006
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 4411 W GORE BLVD STE B1
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City | LAWTON
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State | OK
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Zip | 73505-5977
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Country | US
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Telephone | 580-248-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 W GORE BLVD STE B1
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City | LAWTON
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State | OK
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Zip | 73505-5977
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Country | US
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Telephone | 580-248-8000
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Fax | 580-248-8001
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Authorized Official
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Title or Position | OWNER
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Name | JAROSLAW PASZKOWIAK
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Credential | MD
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Telephone | 580-248-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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