Individual
DR. URSULA GAILLIOT KOEZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
459 LOCUST AVE, MB 26, CHARLOTTESVILLE, VA 22902-4808
(434) 982-7150
(434) 982-7147
Mailing address
PO BOX 11647, DAYTONA BEACH, FL 32120-1647
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101057124
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010142890
—
VA
01
—
166192
ANTHEM SVC/HEALTHKEEPERS
VA
01
—
224992
SOUTHERN HEALTH
VA
01
—
29797
COMMUNITY HEALTH
VA
05
—
29797
—
VA
01
—
930113085
MEDICARE PIN
VA
01
—
P00206926
MEDICARE PIN
VA
Enumeration date
01/24/2006
Last updated
08/06/2008
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