Provider Demographics
NPI:1487616058
Name:COZAD, SCOTT C (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:COZAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6601 WINCHESTER AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4677
Mailing Address - Country:US
Mailing Address - Phone:816-313-2677
Mailing Address - Fax:816-313-6000
Practice Address - Street 1:2529 GLENN HENDREN DR
Practice Address - Street 2:SUITE G40
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-9625
Practice Address - Country:US
Practice Address - Phone:816-415-2147
Practice Address - Fax:816-415-2158
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR3J992085R0001X
KS04-229002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100135400AMedicaid
MO203541602Medicaid
MO4220355AMedicare PIN
KS100135400AMedicaid
MO203541602Medicaid