Koo, David G
Koo, David G is an individual health care provider with primary practice located at 1000 Waterman Way , Tavares FL 32778. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Koo, David G can be contacted via phone (352) 742-8836.Contact Information
Primary practice address
1000 Waterman Way
Tavares FL 32778
Phone: (352) 742-8836
Fax: (352) 742-8829
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME108164 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35075829 | Ohio |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME108164 | Florida |
Profile Details
| NPI number | 1306841044 |
|---|---|
| LBN Legal business name | Koo, David G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2005 |
| Last updated | Jul 18th, 2018 - about 7 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 | 1306841044 | NPPES |
| Ohio | MEDICAID | 2161128 |
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