Individual
KENYA KOZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
304 WRIGHT ST, SWEETWATER, TN 37874-1181
(865) 213-8590
(865) 213-8596
Mailing address
304 WRIGHT ST, SWEETWATER, TN 37874-1181
(865) 213-8590
(865) 213-8596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25483
TN
207RG0100X
Gastroenterology Physician
25483
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083016
—
TN
01
—
4121557
BLUE CROSS
—
Enumeration date
07/13/2005
Last updated
08/11/2008
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