Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2010-00801 | NC |
N | 207X00000X | Orthopaedic Surgeon | T1810 | MS |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 21148 | MS |
NPI | 1295937928 |
---|---|
Provider Name | Dr. John Herrington Kosko |
First Address | Hattiesburg, MS 39401-8246 |
Second Address | Hattiesburg, MS 39401-8246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 27/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | NC |