Provider Demographics
NPI:1043229792
Name:WOJCIK, JOSEPH P (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:WOJCIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 10TH AVE.
Mailing Address - Street 2:
Mailing Address - City:ACKLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50601-1456
Mailing Address - Country:US
Mailing Address - Phone:641-847-2625
Mailing Address - Fax:641-847-2509
Practice Address - Street 1:1000 10TH AVE.
Practice Address - Street 2:
Practice Address - City:ACKLEY
Practice Address - State:IA
Practice Address - Zip Code:50601-1456
Practice Address - Country:US
Practice Address - Phone:641-847-2625
Practice Address - Fax:641-847-2509
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19746207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE54114Medicare UPIN
IAI12856Medicare ID - Type Unspecified
IA7141424Medicare ID - Type Unspecified