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NPI Code Detail

MEDICARE: DR. RONALD EDWARD IZYNSKI I DPM

MEDICARE: DR. RONALD EDWARD IZYNSKI I DPM
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
1213E00000XPodiatrist07000499AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000085473OTHERINANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922145945
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD EDWARD IZYNSKI I DPM
Provider Business Mailing Address
First Line : 601 GATEWAY BLVD N
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-9658
Country : US
Telephone Number : 219-921-1444
Fax Number : 219-921-5303
Provider Business Practice Location Address
First Line : 2501 VALLEY DR
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-2518
Country : US
Telephone Number : 221-992-1144
Fax Number : 219-921-5303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 03/19/2021

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