Provider Demographics
NPI:1265450480
Name:KOSSOW, WILLIAM D (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:KOSSOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:520 S SANTA FE AVE
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4190
Mailing Address - Country:US
Mailing Address - Phone:785-823-8686
Mailing Address - Fax:785-823-8876
Practice Address - Street 1:520 S SANTA FE AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4190
Practice Address - Country:US
Practice Address - Phone:785-823-8686
Practice Address - Fax:785-823-8876
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0424948208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSF85824Medicare UPIN