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NPI Code Detail

MEDICARE: ANDREW JOHN POCZOS JR. PA-C

MEDICARE: ANDREW JOHN POCZOS JR. PA-C
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
1363A00000XPhysician Assistant9207MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2970003981OTHERMNMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184600488
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW JOHN POCZOS JR. PA-C
Provider Business Mailing Address
First Line : 1650 4TH ST SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-4717
Country : US
Telephone Number : 507-529-6600
Fax Number :
Provider Business Practice Location Address
First Line : 1650 4TH ST SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-4717
Country : US
Telephone Number : 507-529-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 08/13/2024

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