Provider Demographics
NPI:1457328486
Name:PARTYKA, EDWARD KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:KENNETH
Last Name:PARTYKA
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 1:800 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5275
Mailing Address - Country:US
Mailing Address - Phone:573-814-6000
Mailing Address - Fax:573-814-6600
Practice Address - Street 1:800 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5275
Practice Address - Country:US
Practice Address - Phone:573-814-6000
Practice Address - Fax:573-814-6600
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95014207R00000X, 207RG0100X
MO2012009726207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2745003-00Medicaid
GA184530713AMedicaid
FLP00303745OtherRAILROAD MEDICARE
FL2745003-00Medicaid
FLA75605Medicare UPIN
FL37035ZMedicare PIN