Healthcare Provider Details

I. General information

NPI: 1235761610
Provider Name (Legal Business Name): LOUIE KOSEGI JR. FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82424 CADIZ JEWETT RD
CADIZ OH
43907-9427
US

IV. Provider business mailing address

380 SUMMIT AVENUE MSO PHYSICIAN BILLING
STEUBENVILLE OH
43952-2667
US

V. Phone/Fax

Practice location:
  • Phone: 740-320-4048
  • Fax: 740-652-6477
Mailing address:
  • Phone: 740-283-7597
  • Fax: 740-283-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026301
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: