Provider Demographics
NPI:1174593131
Name:WALKER KOZIOL, SARA RITCHEY (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:RITCHEY
Last Name:WALKER KOZIOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:RITCHEY
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040
Mailing Address - Country:US
Mailing Address - Phone:205-668-0941
Mailing Address - Fax:205-668-3750
Practice Address - Street 1:11206 HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040
Practice Address - Country:US
Practice Address - Phone:205-668-0941
Practice Address - Fax:205-668-3750
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15973207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2015OtherHEALTH SPRINGS
AL009938511Medicaid
AL1460528OtherUMWA
167582201OtherFED BLACK LUNG
AL4343563OtherAETNA
AL0410040OtherUHC AND MEDICARE COMPLETE
AL51535694OtherBCBS
AL0410040OtherUHC AND MEDICARE COMPLETE
AL1460528OtherUMWA
167582201OtherFED BLACK LUNG