Provider Demographics
NPI:1831395433
Name:WIKIEL, KRZYSZTOF JAN (MD)
Entity type:Individual
Prefix:DR
First Name:KRZYSZTOF
Middle Name:JAN
Last Name:WIKIEL
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 1:4500 E 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3911
Mailing Address - Country:US
Mailing Address - Phone:303-320-7826
Mailing Address - Fax:
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3911
Practice Address - Country:US
Practice Address - Phone:303-320-7826
Practice Address - Fax:303-320-7842
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTRAINING CERTIFICATE208600000X
CODR.0052143208600000X
PAMD442931208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery