Individual
PETER W KOZICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 MOISEY DRIVE, SUITE 202, HAZLETON, PA 18202-9297
(570) 501-6730
(570) 501-3837
Mailing address
PO BOX 1347, KINGSTON, PA 18704-0347
(570) 288-8881
(570) 288-8065
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD020512E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006446160003
—
PA
Enumeration date
07/12/2005
Last updated
05/19/2014
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