Individual
MATTHEW BRIAN KOSAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7100
Mailing address
2600 CAMP BAKER RD, MEDFORD, OR 97501-9608
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201708229NP-PP
OR
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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