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NPI Code Detail

MEDICARE: JOHN DONALD FECZKO MD

MEDICARE: JOHN DONALD FECZKO MD
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
1207ZC0500XCytopathology Physician01041467AIN
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician01041467AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1351173213OTHERSAGAMORE
2737122002OTHERCIGNA
3351173213OTHERHFN
482426OTHERBCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6351173213OTHERISPAT INLAND

General Provider Information

NPI Number : 1710970603
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DONALD FECZKO MD
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 85 E US HIGHWAY 6
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-8947
Country : US
Telephone Number : 219-983-8300
Fax Number : 219-983-8014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 01/23/2024

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Directions to “ JOHN DONALD FECZKO MD” Practice Location

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