Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 44532 | WI |
Y | 207VX0000X | Obstetrician | 44532 | WI |
NPI | 1164530333 |
---|---|
Provider Name | James J Kiyak |
First Address | Toledo, OH 43620-1402 |
Second Address | Toledo, OH 43620-1402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 07/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34274200 | (05) | WI |