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NPI Code Detail

MEDICARE: PETER KOZLOWSKI MD PA

MEDICARE: PETER KOZLOWSKI MD PA
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1972986669
Entity Type Code : Organization
Provider Name (Legal Business Name) : PETER KOZLOWSKI MD PA
Provider Business Mailing Address
First Line : 2010 LEWIS TURNER BLVD
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-1352
Country : US
Telephone Number : 850-863-3000
Fax Number :
Provider Business Practice Location Address
First Line : 2010 LEWIS TURNER BLVD
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-1352
Country : US
Telephone Number : 850-863-3000
Fax Number :
Authorized Official
Title or Position : OWNER/PROVIDER
Name : PETER KOZLOWSKI
Credential : MD
Telephone Number : 850-863-3000
Provider Enumeration Date : 06/30/2015
Last Update Date : 06/30/2015

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