Provider Demographics
NPI:1841253762
Name:KOZIOL, ISAAC (MD)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:KOZIOL
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 1:9105 STONY POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1979
Mailing Address - Country:US
Mailing Address - Phone:804-287-1030
Mailing Address - Fax:804-288-3529
Practice Address - Street 1:9105 STONY POINT PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1979
Practice Address - Country:US
Practice Address - Phone:804-287-1030
Practice Address - Fax:804-288-3529
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101 019890208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA212764OtherCIGNA
VA577464516OtherTRICARE
VA340019027OtherRAILROAD MEDICARE
VAC04057OtherMEDICARE GROUP #
VA59336OtherSOUTHERN HEALTH
VA1900005OtherUNITED HEALTHCARE
VA007500947Medicaid
VA790472OtherAETNA HMO
VA37055OtherCARENET
VA080210000-00OtherQUALCHOICE
VA35758OtherALLIANCE
VACC6581OtherRAILROAD MEDICARE GROUP #
VA4063463OtherAETNA PPO
VA45725OtherSENTARA FAMILY CARE
VA080210000-00OtherQUALCHOICE
VA1900005OtherUNITED HEALTHCARE
VA016595V08Medicare UPIN