| Randy B Kozel, MD | |
|
112 Clock Tower Square, Portsmouth, RI 02871-1365 | |
| (401) 683-9002 | |
| (401) 293-0330 |
| Full Name | Randy B Kozel |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 112 Clock Tower Square, Portsmouth, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699775486 | NPI | - | NPPES |
| 1208 | Other | RI | NEIGHBORHOOD HEALTH PLAN |
| 0000026648 | Other | RI | BLUE SHIELD |
| 007702 | Other | TUFTS HEALTH PLAN | |
| 3396039 | Other | AETNA US HEALTHCARE | |
| AA92335 | Other | HARVARD PILGRIM | |
| 9227027 | Other | CIGNA HEALTHCARE | |
| P00130048 | Other | RAILROAD MEDICARE | |
| RK51170 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD07702 (Rhode Island) | Primary |
| Entity Name | Southcoast Physicians Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336137629 PECOS PAC ID: 0749171957 Enrollment ID: O20050502000716 |
| Mailing Address | Practice Location Address |
|---|---|
| Randy B Kozel, MD 200 Mill Rd, Suite 180, Fairhaven, MA 02719-5252 Ph: (508) 973-2000 | Randy B Kozel, MD 112 Clock Tower Square, Portsmouth, RI 02871-1365 Ph: (401) 683-9002 |
Susanne J Patrick-mackinnon, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2444 E Main Rd, Portsmouth, RI 02871 Phone: 401-683-1048 Fax: 401-683-1239 | |
Grace A. Medeiros, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 2444 E Main Rd, Portsmouth, RI 02871 Phone: 401-683-1048 Fax: 401-683-1239 |