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Individual

KEVIN R KOZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Mailing address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036121114
IL
2085R0001X
Radiation Oncology Physician
Primary
51615
WI
2085R0001X
Radiation Oncology Physician
ME148357
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109765700
FL
01
HVZ5R
FL BLUE
FL
01
KOZAKKEV
MERCYCARE INSURANCE
WI
01
NO241
MEDICARE
FL
Enumeration date
08/05/2007
Last updated
06/23/2025
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