Individual
LISA KOZODOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD STE 2009B, SAINT LOUIS, MO 63141-8265
(314) 251-6062
Mailing address
13215 2ND AVE S, BURIEN, WA 98168-2637
(206) 687-8336
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2025021583
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2025
Last updated
06/25/2025
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