Individual
DR. JEFFREY DAVID KOZLOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
336 GEORGIA AVE, SUITE 102, NORTH AUGUSTA, SC 29841-3849
(803) 442-3006
(803) 642-0754
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1102
SC
152W00000X
Optometrist
Primary
1734
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA73227125
MEDICARE PTAN
SC
05
—
DN1734
—
SC
Enumeration date
12/13/2005
Last updated
05/04/2022
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