Provider Demographics
NPI:1114954328
Name:KOZIN, FRANK DONALD (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DONALD
Last Name:KOZIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2043
Mailing Address - Country:US
Mailing Address - Phone:248-363-6405
Mailing Address - Fax:248-363-0314
Practice Address - Street 1:8212 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-2229
Practice Address - Country:US
Practice Address - Phone:313-291-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002110152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist