Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 17569 | AZ |
NPI | 1154327815 |
---|---|
Provider Name | Dr. Stuart Craig Kozinn |
First Address | Scottsdale, AZ 85251-1943 |
Second Address | Scottsdale, AZ 85258-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 18/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276479 | (05) | AZ |
B98023 | (02) |