Provider Demographics
NPI:1841482502
Name:BOZAK, DAVID J (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BOZAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3000 FAIRWAY DRIVE
Mailing Address - Street 2:BLAIR ORTHOPEDICS
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602
Mailing Address - Country:US
Mailing Address - Phone:814-942-1166
Mailing Address - Fax:814-942-6222
Practice Address - Street 1:3000 FAIRWAY DRIVE
Practice Address - Street 2:BLAIR ORTHOPEDICS
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-942-1166
Practice Address - Fax:814-942-6222
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP21938208100000X
PAOS015167208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation