Healthcare Provider Details

I. General information

NPI: 1568955995
Provider Name (Legal Business Name): AKOS MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20565 N 19TH AVE
PHOENIX AZ
85027
US

IV. Provider business mailing address

PO BOX 41638
PHOENIX AZ
85080-1638
US

V. Phone/Fax

Practice location:
  • Phone: 844-900-2567
  • Fax:
Mailing address:
  • Phone: 480-395-8211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY M COZATT
Title or Position: CHIEF OPERATING OFFICER
Credential: MBA
Phone: 480-395-8211