Provider Demographics
NPI:1336497213
Name:KRZEPICKI, JACEK (MD)
Entity Type:Individual
Prefix:DR
First Name:JACEK
Middle Name:
Last Name:KRZEPICKI
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 1:43568 YORKSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4541
Mailing Address - Country:US
Mailing Address - Phone:703-858-7081
Mailing Address - Fax:
Practice Address - Street 1:43568 YORKSHIRE CT
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4541
Practice Address - Country:US
Practice Address - Phone:703-858-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.075542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine