NPI 1609339753

Jeremiah Mathew Cozby

Practitioner Legal Medicine Heavener, OK

Practice location

Address: 27440 Potts Mtn Rd, Heavener, OK 74937-3698
Phone: (918) 413-2678

Registered specialties

Legal Medicine Primary

Other Service Providers Taxonomy 173000000X Licence GAAA-NYOA-BIMU (OK)

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Registry record

NPI: 1609339753
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Apr 2019
Record last updated: 7 Apr 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.