Organization
ROGUE VALLEY EAR, NOSE, THROAT & FACIAL PLASTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A KOZAK D.O. (OWNER)
(541) 479-2600
Entity
Organization
Contact information
Practice address
1601 NE 6TH ST, GRANTS PASS, OR 97526-1035
(541) 479-2600
(541) 479-2990
Mailing address
1601 NE 6TH ST, GRANTS PASS, OR 97526-1035
(541) 479-2600
(541) 479-2990
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150358
—
OR
Enumeration date
01/26/2009
Last updated
01/26/2009
Update your record
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