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Contact Information

JEREMY C CUZZOURT, MD
98 STATE ST
PROCTORVILLE, OH45669-8163
 Phone: 855-446-5937
 Fax: 740-886-9374
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for JEREMY C CUZZOURT · (Male)

NPI # 1013948694
Status Active
Credentials MD
Entity Individual
Enumeration date 07/05/2006
Last updated 01/21/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 35.125222
  • TN License # 46380
  • WV License # 22299
  • KY Medicaid 64127202
  • OH Medicaid 2667234
  • TN Medicaid 1519145
  • WV Medicaid 3810005553
  • Other P00324289 RAILROAD MEDICARE
Hospital affiliation(s)
  • ST MARY'S MEDICAL CENTER - (Acute Care)
    2900 1ST AVENUE
    HUNTINGTON, WV 25701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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