MEDICARE: STEVEN V KOZMARY MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP3300X	Pain Clinic/Center
2	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063579803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN V KOZMARY MD LLC

Provider Business Mailing Address
First Line	:	2851 EL CAMINO AVE STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4266
Country	:	US
Telephone Number	:	702-380-3210
Fax Number	:	702-380-3212

Provider Business Practice Location Address
First Line	:	2851 EL CAMINO AVE
Second Line	:	STE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89102
Country	:	US
Telephone Number	:	702-380-3210
Fax Number	:	702-380-3212

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	STEVEN V KOZMARY
Credential	:	MD
Telephone Number	:	702-380-3210

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	05/18/2018

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