Provider Demographics
NPI:1972896413
Name:KOSHY, JASON THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:THOMAS
Last Name:KOSHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746559
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6559
Mailing Address - Country:US
Mailing Address - Phone:409-938-5057
Mailing Address - Fax:
Practice Address - Street 1:6801 EMMETT F LOWRY EXPY
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2500
Practice Address - Country:US
Practice Address - Phone:409-938-5057
Practice Address - Fax:409-938-5175
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6758207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology