Individual
DR. DOUGLAS LEE KOSMICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3515 RICHMOND CIRCLE, GRAND ISLAND, NE 68803-4965
(308) 381-8636
(308) 381-8622
Mailing address
7440 S 91ST ST, LINCOLN, NE 68526-9797
(402) 489-6555
(402) 328-3770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24681
NE
207RC0000X
Cardiovascular Disease Physician
24681
NE
207RI0011X
Interventional Cardiology Physician
Primary
24681
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0202486
—
IA
05
—
10026072300
—
NE
05
—
10026072400
—
NE
05
—
10026072500
—
NE
05
—
1202489
—
IA
05
—
200567060A
—
KS
05
—
47070592300
—
NE
05
—
47070592301
—
NE
05
—
47070592302
—
NE
05
—
47070592305
—
NE
05
—
47070592306
—
NE
05
—
47070592313
—
NE
Enumeration date
08/20/2006
Last updated
02/01/2012
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