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Individual

RONALD J. KOSSOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3700 SOUTHERN BLVD STE 101, KETTERING, OH 45429-1226
(937) 281-3810
(937) 281-3812
Mailing address
PO BOX 713100, SALT LAKE CITY, UT 84171-3100
(801) 930-3842
(866) 588-2820

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
35130569
OH
2085R0001X
Radiation Oncology Physician
MD070743L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1018952570001
PA
05
3810011126
WV
Enumeration date
09/14/2005
Last updated
07/21/2022
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