Provider Demographics
NPI:1760481105
Name:GOZA, JOHN SAMS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SAMS
Last Name:GOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 741331
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1331
Mailing Address - Country:US
Mailing Address - Phone:913-469-0503
Mailing Address - Fax:913-469-5267
Practice Address - Street 1:10600 MASTIN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5723
Practice Address - Country:US
Practice Address - Phone:913-469-6447
Practice Address - Fax:913-338-1311
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2012-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0434297208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200640850AMedicaid
KS200640850AMedicaid
KSKA1613005Medicare PIN
KS553A00079Medicare PIN