| Mark R Vytlacil, MD | |
|
6308 8th Ave, Kenosha, WI 53143-5031 | |
| (262) 656-2943 | |
| (262) 656-2749 |
| Full Name | Mark R Vytlacil |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 6308 8th Ave, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033272174 | NPI | - | NPPES |
| 34409200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 45815 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mark R Vytlacil, MD Po Box 130, Kenosha, WI 53141-0130 Ph: (262) 656-2943 | Mark R Vytlacil, MD 6308 8th Ave, Kenosha, WI 53143-5031 Ph: (262) 656-2943 |
Robert Bjork, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-5542 Fax: 262-656-2749 | |
Jamie Rae Mings, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-2294 | |
James C Kranz, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-2943 Fax: 262-656-2749 | |
Leela C Thachenkary, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 7107-49th Ave, Kenosha, WI 53142 Phone: 262-694-1292 | |
Maysoon A Razzak, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 10400 75th Street, Kenosha, WI 53142 Phone: 262-948-5690 Fax: 262-948-7327 |