MEDICARE: MINE OYA OZKAZANC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35072810O	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083604110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINE OYA OZKAZANC MD

Provider Business Mailing Address
First Line	:	300 TWINING ST
Second Line	:	BLDG 760
City	:	MONTGOMERY
State	:	AL
Zip	:	36112-6027
Country	:	US
Telephone Number	:	334-953-9262
Fax Number	:	334-953-8607

Provider Business Practice Location Address
First Line	:	300 TWINING ST
Second Line	:	BLDG 760
City	:	MONTGOMERY
State	:	AL
Zip	:	36112-6027
Country	:	US
Telephone Number	:	333-495-3926
Fax Number	:	334-953-8607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	10/08/2014

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