Provider Demographics
NPI:1326571449
Name:PAVNICA, JOZEF WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:JOZEF
Middle Name:WILLIAM
Last Name:PAVNICA
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 1:3730 PLAZA WAY FL 5
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2718
Mailing Address - Country:US
Mailing Address - Phone:509-221-6550
Mailing Address - Fax:506-221-6511
Practice Address - Street 1:3730 PLAZA WAY FL 5
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2718
Practice Address - Country:US
Practice Address - Phone:509-221-6550
Practice Address - Fax:509-221-6511
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37455208600000X
390200000X
WA61314680208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program