Provider Demographics
NPI:1528182672
Name:COZART, JASON F (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:F
Last Name:COZART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1645
Mailing Address - Country:US
Mailing Address - Phone:724-852-4222
Mailing Address - Fax:724-852-4222
Practice Address - Street 1:1159 6TH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1645
Practice Address - Country:US
Practice Address - Phone:724-852-4222
Practice Address - Fax:724-852-4222
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008737111N00000X, 111NN0400X, 111NN1001X, 111NR0200X, 111NR0400X, 111NS0005X, 111NT0100X, 111NX0100X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0200XChiropractic ProvidersChiropractorRadiology
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NT0100XChiropractic ProvidersChiropractorThermography
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030409OtherPEBTF
PA0007344375OtherAETNA
PA054874WZ9OtherMEDICARE
PA409113OtherHEALTH AMERICA-ADVANTRA
PA1030409OtherHEALTH ASSURANCE