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General NPI Number Information
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NPI Number | 1932375789
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Entity Type | Organization
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Legal Business Name | JOHN S KOSTIN MD PC
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 6010 GULL RD
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City | KALAMAZOO
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State | MI
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Zip | 49048-9452
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Country | US
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Telephone | 269-381-6157
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Fax | 269-385-2657
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Provider Business Mailing Address
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Address Line | 6010 GULL RD
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City | KALAMAZOO
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State | MI
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Zip | 49048-9452
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Country | US
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Telephone | 269-381-6157
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Fax | 269-385-2657
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | TERI M CASWELL
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Credential |
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Telephone | 269-381-6157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | JK194300
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License Number State | MI
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