JACK P. KOTLARZ MD – NPI #1922090646
Otolaryngology
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
JACK KOTLARZ is an otolaryngologist located in ROCKFORD, IL. NPPES has assigned the NPI number 1922090646 to JACK KOTLARZ on August 18, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI Registry, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207YX0007X from the Health Care Provider Taxonomy code set, which is classified as Otolaryngology, specializing in Plastic Surgery within the Head & Neck
The NPI profile was last updated on Dec 10, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACK KOTLARZ below.
NPI Profile for
JACK P. KOTLARZ
(about 21 years ago)
ROCKFORD, IL 61107-2201 Phone: (779) 696-9201 Fax: (815) 397-9667
2 Other location(s):
Pensacola, FL 32504-6950
Phone: (850) 471-2377
Fax: (850) 471-9975
Tampa, FL 33613-4613
Phone: (813) 971-6000
Fax: (813) 615-7542
PENSACOLA, FL 32504-6950 Phone: (850) 471-2377 Fax: (850) 471-9975
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for JACK KOTLARZ
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
See identifiers
| Description | Issuer | State | Identifier |
|---|---|---|---|
| other | AETNA | FL | 4314144 |
| other | BCBS OF ALA | AL | 590 51780 |
| other | BCBS OF FLORIDA | FL | 42544 |
| other | CIGNA PPO | FL | 7618346003 |
| other | MEDICAID ALA | AL | 009900475 |
| other | UHC MCR RR | FL | 040016528 |
| medicaid | FL | 253548300 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 207YX0007X - Otolaryngology / Plastic Surgery within the Head & Neck (Primary) |
IL | 036170362 |
| 207Y00000X - Otolaryngology |
MO | 2024013411 |
| 174400000X - Specialist |
FL | ME62757 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
JACK KOTLARZ is affiliated with the following medical group(s):
- HOSPITAL
- BAPTIST HOSPITAL1000 W MORENO ST
PENSACOLA, FL 32501 - SACRED HEART HOSPITAL5151 N 9TH AVE
PENSACOLA, FL 32504
- BAPTIST HOSPITAL1000 W MORENO ST
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