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Individual

DR. MARK GILL KOSKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1200 N STATE ST, STE 330, JACKSON, MS 39202-2027
(601) 353-2020
(601) 352-5988
Mailing address
1200 N STATE ST, STE 330, JACKSON, MS 39202-2027
(601) 353-2020
(601) 714-5110

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23717
MS
207W00000X
Ophthalmology Physician
MD.33192
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05508385
MS
Enumeration date
05/11/2010
Last updated
03/18/2019
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