Provider Demographics
NPI:1528171824
Name:KOZAR, CHRISTINA A (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:KOZAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7007
Mailing Address - Country:US
Mailing Address - Phone:540-379-3623
Mailing Address - Fax:540-408-0428
Practice Address - Street 1:3708 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7007
Practice Address - Country:US
Practice Address - Phone:540-739-3623
Practice Address - Fax:540-739-3979
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204256208000000X
CT040307208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics