Healthcare Provider Details

I. General information

NPI: 1841283744
Provider Name (Legal Business Name): ALBERT J KOZAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALBERT J KOZAR DO

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VCOM SPORTS & OSTEOPATHIC MEDICINE, 1691 INNOVATION DR, SUITE 2100
BLACKSBURG VA
24060
US

IV. Provider business mailing address

1691 INNOVATION DR STE 2100
BLACKSBURG VA
24060-6618
US

V. Phone/Fax

Practice location:
  • Phone: 540-232-8405
  • Fax: 833-464-3281
Mailing address:
  • Phone: 540-232-8405
  • Fax: 833-464-3281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number0102204269
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number0102204269
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: