Eric A Kivisto is a Surgery in Mendota, Illinois. Eric A Kivisto practices all healthcare services and medical treatments related to Surgery. The NPI Number for Eric A Kivisto is 1447257316. The last update date is 2022-12-07.
Eric A Kivisto's current location address is 1401 E 12th St, Mendota, Illinois. You can contact this provider via phone number 8155391789 and fax number 8155391430. The mailing address for Eric A Kivisto is 1401 E 12th St, Mendota, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Eric A Kivisto |
|---|---|
| Address | 1401 E 12th St, Mendota, Illinois |
| Phone Number | 8155391789 |
| Fax Number | 8155391430 |
| Sole Proprietor | N |
| Credentials | DO |
NPI Number Detail
| NPI Number | 1447257316 |
|---|---|
| Provider Enumeration Date | 2005-07-06 |
| Last Updated Date | 2022-12-07 |
Provider Mailing Address Detail
| Address | 1401 E 12th St |
|---|---|
| City | Mendota |
| State | Illinois (IL) |
| Post Code | 613429216 |
| Phone Number | 8155391789 |
| Fax Number | 8155391430 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 5101011210 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 371342699 | IL | FEIN NUMBER | |
| 36091073 | IL | -- | |
| 2706617 | IL | BLUE CROSS/BLUE SHIELD |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Eric A Kivisto by the Centers for Medicare & Medicaid Services?
The Eric A Kivisto has been assigned the NPI (National Provider Identifier) 1447257316 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Eric A Kivisto is geographically located?
The Eric A Kivisto is physically situated at the following location: 1401 E 12Th St, Mendota, IL, 613429216.
What is Eric A Kivisto's area of expertise and its corresponding taxonomy classification?
The Eric A Kivisto's field of specialization is Surgery, and it falls under the taxonomy code 208600000X, which categorizes healthcare providers based on their areas of practice.
What is Eric A Kivisto's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Eric A Kivisto is Surgery, and the taxonomy code that classifies this field of practice is 208600000X.
As of what date were the details pertaining to Eric A Kivisto last refreshed?
The information related to the Eric A Kivisto, including its address, specialty, and other relevant details, was last updated on 2022-12-07.