Healthcare Provider Details

I. General information

NPI: 1144203456
Provider Name (Legal Business Name): WILLIAM Z KOLOZSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 E STATE ST STE B
SALEM OH
44460-4409
US

IV. Provider business mailing address

2094 E STATE ST STE B
SALEM OH
44460-4409
US

V. Phone/Fax

Practice location:
  • Phone: 330-337-8709
  • Fax: 330-337-9019
Mailing address:
  • Phone: 330-337-8709
  • Fax: 330-337-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35045297K
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: