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Individual
KYLER KOZACEK
Active
Individual
KYLER KOZACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2171
NE
207RG0100X
Gastroenterology Physician
Primary
2171
NE
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VAD000
MEDICARE UPIN
—
Enumeration date
04/19/2016
Last updated
03/31/2026
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