Provider Demographics
NPI:1467588376
Name:JOZWIAK, ROBERT FLOYD (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FLOYD
Last Name:JOZWIAK
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 1:113 COMMERCE PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6055
Mailing Address - Country:US
Mailing Address - Phone:614-882-9131
Mailing Address - Fax:614-882-9133
Practice Address - Street 1:113 COMMERCE PARK DR STE A
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6055
Practice Address - Country:US
Practice Address - Phone:614-882-9131
Practice Address - Fax:614-882-9133
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2871T504152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0156281Medicaid
OH11583050OtherCAQH ID
OH0156281Medicaid
OHP00193225Medicare PIN
OHT46675Medicare UPIN