Provider Demographics
NPI:1629492376
Name:KOBZA, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:KOBZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BROADKILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-1008
Mailing Address - Country:US
Mailing Address - Phone:302-684-5700
Mailing Address - Fax:302-684-5702
Practice Address - Street 1:104 BROADKILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1008
Practice Address - Country:US
Practice Address - Phone:302-684-5700
Practice Address - Fax:302-684-5702
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE310633156FX1800X
156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician