Healthcare Provider Details

I. General information

NPI: 1598554461
Provider Name (Legal Business Name): KEVIN DUSZYK JR. PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MDG 655 SEVENTH STREET ROBINS AFB
WARNER ROBINS GA
31098-2440
US

IV. Provider business mailing address

78 MDG 655 SEVENTH STREET
WARNER ROBINS GA
31093
US

V. Phone/Fax

Practice location:
  • Phone: 726-220-3027
  • Fax:
Mailing address:
  • Phone: 478-327-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1249828
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: