Healthcare Provider Details

I. General information

NPI: 1801716568
Provider Name (Legal Business Name): DOGWOOD DERMATOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 LEE JACKSON HWY STE 101
STAUNTON VA
24401-9504
US

IV. Provider business mailing address

427 LEE JACKSON HWY STE 101
STAUNTON VA
24401-9504
US

V. Phone/Fax

Practice location:
  • Phone: 540-458-9450
  • Fax: 540-237-1815
Mailing address:
  • Phone: 540-458-9450
  • Fax: 540-237-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MERRICK KOZAK
Title or Position: OWNER
Credential: MD
Phone: 540-458-9450