Provider Demographics
NPI:1609854579
Name:KOZLOWSKI, KARA M (DPM, FACFAS)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:M
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:DPM, FACFAS
Other - Prefix:
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Mailing Address - Street 1:3009 N BALLAS RD
Mailing Address - Street 2:STE 100B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2322
Mailing Address - Country:US
Mailing Address - Phone:636-587-3668
Mailing Address - Fax:636-587-3774
Practice Address - Street 1:521 N VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-1115
Practice Address - Country:US
Practice Address - Phone:636-587-3668
Practice Address - Fax:636-587-3774
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO000651213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
202141604OtherCCO GENERAL MEDICAL
202141604OtherCOMMUNITY CARE PLUS
MO106623OtherBLUE CROSS BLUE SHIELD
202141604OtherBEECH STREET
202141604OtherGALAXY
4604670OtherAETNA
202141604OtherCCN
202141604OtherGREAT WEST
202141604OtherEVOLUTIONS
202141604OtherHFN
202141604OtherCIGNA
MO306929944Medicaid
MO306929951Medicaid
O86254OtherEXCLUSIVE CHOICE
MOP00233973OtherRR MEDICARE
231935OtherGHP
4706OtherHEALTHCARE USA
254476OtherHEALTHLINK
MOP00233973OtherRR MEDICARE
202141604OtherGREAT WEST
202141604OtherCOMMUNITY CARE PLUS