Provider Demographics
NPI:1710169974
Name:KOSIER, MARILYN KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:KAY
Last Name:KOSIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1303
Mailing Address - Country:US
Mailing Address - Phone:740-654-8424
Mailing Address - Fax:740-654-0505
Practice Address - Street 1:1520 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1303
Practice Address - Country:US
Practice Address - Phone:740-654-0177
Practice Address - Fax:740-654-0505
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-6213K174400000X
OH35-056213207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000119171OtherANTHEM
OH0698142Medicaid
OH0698142Medicaid
OH180005676Medicare PIN