Koch, John Kevin
Koch, John Kevin is an individual health care provider with primary practice located at 800 Grand Central Mall Suite 2, Vienna WV 26105-4100. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Koch, John Kevin can be contacted via phone (304) 865-4350.Contact Information
Primary practice address
800 Grand Central Mall Suite 2
Vienna WV 26105-4100
Phone: (304) 865-4350
Fax: (304) 865-4348
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 19553 | West Virginia |
Profile Details
| NPI number | 1104824044 |
|---|---|
| LBN Legal business name | Koch, John Kevin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Aug 11th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104824044 | NPPES |
| West Virginia | MEDICAID | 0011154000 | |
| West Virginia | MEDICAID | 2197448 | |
| West Virginia | Other | 311599387-00 | |
| West Virginia | Other | 201655 | |
| West Virginia | Other | 311599387003 | |
| West Virginia | Other | 9298571 |
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