Provider Demographics
NPI:1215915442
Name:KOTZIN, SCOTT AARON (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:AARON
Last Name:KOTZIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45216-1015
Mailing Address - Country:US
Mailing Address - Phone:513-418-5700
Mailing Address - Fax:513-418-5773
Practice Address - Street 1:175 W GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-1015
Practice Address - Country:US
Practice Address - Phone:513-418-5700
Practice Address - Fax:513-418-5773
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-6559K207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2344967Medicaid
OH2344967Medicaid
OH0851254Medicare PIN
OHBK5124843OtherDEA