Individual
HENRY KOZDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
684 N PORT CRESCENT ST, BAD AXE, MI 48413-1275
(989) 912-6575
(989) 912-6013
Mailing address
684 N PORT CRESCENT ST, BAD AXE, MI 48413-1275
(989) 912-6575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101027382
MI
207Q00000X
Family Medicine Physician
5151014202
MI
390200000X
Student in an Organized Health Care Education/Training Program
5151014202
MI
Other
Enumeration date
06/11/2020
Last updated
09/25/2023
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