MEDICARE: MR. JOSEPH S. KOZLOWSKI JR. D.O.

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	207Q00000X	Family Medicine Physician	5101007058	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	853338574	OTHER	MI	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366420432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH S. KOZLOWSKI JR. D.O.

Provider Business Mailing Address
First Line	:	1003 E MOUNT HOPE AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-1822
Country	:	US
Telephone Number	:	517-853-3704
Fax Number	:	517-853-3701

Provider Business Practice Location Address
First Line	:	1003 E MOUNT HOPE AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-1822
Country	:	US
Telephone Number	:	517-853-3704
Fax Number	:	517-853-3701

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	08/28/2015

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Directions to “ MR. JOSEPH S. KOZLOWSKI JR. D.O.” Practice Location

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