Provider Demographics
NPI:1083604110
Name:OZKAZANC, MINE OYA (MD)
Entity Type:Individual
Prefix:
First Name:MINE
Middle Name:OYA
Last Name:OZKAZANC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MINE
Other - Middle Name:OYA
Other - Last Name:OKTENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 TWINING ST
Mailing Address - Street 2:BLDG 760
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36112-6027
Mailing Address - Country:US
Mailing Address - Phone:334-953-9262
Mailing Address - Fax:334-953-8607
Practice Address - Street 1:300 TWINING ST
Practice Address - Street 2:BLDG 760
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36112-6027
Practice Address - Country:US
Practice Address - Phone:333-495-3926
Practice Address - Fax:334-953-8607
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072810O208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2059801Medicaid
E24698Medicare UPIN