Organization
KEN KOZAWA I MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA KOZAWA MD (OWNER)
(865) 213-8590
Entity
Organization
Contact information
Practice address
304 WRIGHT ST, SWEETWATER, TN 37874-1181
(865) 213-8200
(865) 213-8596
Mailing address
304 WRIGHT ST, SWEETWATER, TN 37874-1181
(865) 213-8200
(865) 213-8596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25483
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3733125
—
TN
01
—
4121508
BC
—
Enumeration date
07/21/2005
Last updated
05/01/2009
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