Provider Demographics
NPI:1275538498
Name:COZART, DAVID T (MD, FACS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:COZART
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 S JACKSON HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5770
Mailing Address - Country:US
Mailing Address - Phone:256-314-6947
Mailing Address - Fax:256-314-6902
Practice Address - Street 1:1120 S JACKSON HWY STE 203
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5770
Practice Address - Country:US
Practice Address - Phone:256-314-6947
Practice Address - Fax:256-314-6902
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26645208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN020025948OtherRAILROAD MEDICARE
TN4674488OtherAETNA
TN3031352OtherBLUE CROSS OF TN
TN3091276Medicaid
TN3031352OtherBLUE CROSS OF TN