Individual
DR. KEVIN KOSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
501 BAPTIST DR STE 220, MADISON, MS 39110-2031
(601) 985-9120
(601) 985-9122
Mailing address
501 BAPTIST DR STE 220, MADISON, MS 39110-2031
(601) 985-9120
(601) 985-9122
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20492
MS
207W00000X
Ophthalmology Physician
T-1953
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08520364
—
MS
01
—
123322
ALABAMA MEDICAID
AL
01
—
DN2775
MEDICARE RAILROAD-GROUP
MS
Enumeration date
05/23/2007
Last updated
10/22/2024
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