| Stefan Rozycki, MD | |
| 200 Mercy Circle, Camp Pendleton, CA 92055 | |
| (760) 719-3385 | |
| Not Available | 
| Full Name | Stefan Rozycki | 
|---|---|
| Gender | Male | 
| Speciality | Otolaryngology | 
| Location | 200 Mercy Circle, Camp Pendleton, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1538401146 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Y00000X | Otolaryngology | 036164948 (Illinois) | Secondary | 
| 207Y00000X | Otolaryngology | 28023 (Nebraska) | Primary | 
| Entity Name | Southern Illinois Medical Services Nfp | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Stefan Rozycki, MD Po Box 555191, Camp Pendleton, CA 92055-5191 Ph: (919) 949-7502 | Stefan Rozycki, MD 200 Mercy Circle, Camp Pendleton, CA 92055 Ph: (760) 719-3385 | 
| Dr. Michael Jack Coulter, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 200 Mercy Circle, Camp Pendleton, CA 92055 Phone: 760-725-6646 | |
| Dr. Daniel J Zinder, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: I Mef Hsse, Attn Mssp Bldg 210721 C St, Camp Pendleton, CA 92055 Phone: 760-725-9158 | |
| Dr. Gretchen Collins Taylor, M. D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: Psc 477 Box 555191, Us Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055 Phone: 760-725-1480 | |
| Michael Baxter, M.D., MSC Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 200 Mercy Circle, Camp Pendleton, CA 92055 Phone: 760-725-6646 |