Healthcare Provider Details

I. General information

NPI: 1558370007
Provider Name (Legal Business Name): ALLEN F KOSSOY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 06/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SW GARFIELD AVE
TOPEKA KS
66606-1670
US

IV. Provider business mailing address

901 SW GARFIELD AVE
TOPEKA KS
66606-1670
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-9591
  • Fax: 785-368-0713
Mailing address:
  • Phone: 785-354-9591
  • Fax: 785-368-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number05-22557
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: