Provider Demographics
NPI:1730168402
Name:MARILYN K. KOSIER, M.D., INC.
Entity type:Organization
Organization Name:MARILYN K. KOSIER, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-654-8424
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:740-654-8424
Practice Address - Fax:740-654-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000119171OtherANTHEM
OH0698142Medicaid
OH000000119171OtherANTHEM