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NPI Code Detail

MEDICARE: DR. JOHN ALEXANDER SIELATYCKI M.D.

MEDICARE: DR. JOHN ALEXANDER SIELATYCKI M.D.
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
1207XS0117XOrthopaedic Surgery of the Spine Physician52387TN
2390200000XStudent in an Organized Health Care Education/Training Program
3207XS0117XOrthopaedic Surgery of the Spine PhysicianDR.0068008CO

General Provider Information

NPI Number : 1629335658
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ALEXANDER SIELATYCKI M.D.
Provider Business Mailing Address
First Line : 705 MARKETPLACE PLZ STE 200
Second Line :
City : STEAMBOAT SPRINGS
State : CO
Zip : 80487-1841
Country : US
Telephone Number : 970-879-6663
Fax Number : 970-871-1234
Provider Business Practice Location Address
First Line : 705 MARKETPLACE PLZ STE 200
Second Line :
City : STEAMBOAT SPRINGS
State : CO
Zip : 80487-1841
Country : US
Telephone Number : 970-879-6663
Fax Number : 970-871-1234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2012
Last Update Date : 05/27/2022

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