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
Fax: (304) 865-4348
Website:

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
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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