Provider Demographics
NPI:1700863149
Name:JOZIC, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:JOZIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 MCNAUGHTEN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-5111
Mailing Address - Country:US
Mailing Address - Phone:614-627-2000
Mailing Address - Fax:
Practice Address - Street 1:85 MCNAUGHTEN RD STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-5111
Practice Address - Country:US
Practice Address - Phone:614-627-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-082639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200509190Medicaid
KY000000295647OtherANTHEM BCBS
OH2791313Medicaid
KY64066806Medicaid
KY0614813Medicare ID - Type Unspecified
KY64066806Medicaid
KY000000295647OtherANTHEM BCBS
KY0614714Medicare ID - Type Unspecified
KY0758307Medicare ID - Type Unspecified
OH2791313Medicaid
OHP00690301Medicare PIN