Eric A Kivisto, DO

NPI #1447257316 in Mendota, Illinois

Provider Information

NPI Number: 1447257316
Entity Type: Individual
Name: Eric A Kivisto, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Surgery
Credential: DO
Enumeration Date: Jul 6, 2005
Last Updated: Dec 7, 2022

Practice Location

Address: 1405 E 12TH ST
Address 2: SUITE 500
City: Mendota
State: Illinois
ZIP Code: 61342-9010
Phone: (815) 539-1789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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Organizations

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