Provider Demographics
NPI:1295912509
Name:WOJCIECH ZOLCIK M.D. P.C.
Entity type:Organization
Organization Name:WOJCIECH ZOLCIK M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WOJCIECH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOLCIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-674-1665
Mailing Address - Street 1:PO BOX 7060
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716
Mailing Address - Country:US
Mailing Address - Phone:307-674-1720
Mailing Address - Fax:307-687-7243
Practice Address - Street 1:101 W BRUNDAGE ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-4217
Practice Address - Country:US
Practice Address - Phone:307-674-1665
Practice Address - Fax:307-687-7243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6219A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY115107000Medicaid