Individual
MR. ERIC JON KOZLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 DAVIS ST, ASHEBORO, NC 27203
(336) 629-5770
(336) 629-0130
Mailing address
100 WESTWOOD AVENUE, HIGH POINT, NC 27262-4320
(336) 883-1393
(336) 883-7517
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
9500975
NC
207R00000X
Internal Medicine Physician
9500975
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202020
UNITED HEALTHCARE
—
01
—
1235298589
GROUP NPI
NC
01
—
2217701A
MEDICARE ID
NC
01
—
2217701B
MEDICARE ID
NC
01
—
50259
BCBS
NC
05
—
8950259
—
NC
Enumeration date
04/26/2006
Last updated
09/17/2021
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