Koller, John M

Koller, John M is an individual health care provider with primary practice located at 202 Center Ave. Ste. 102, Kodiak AK 99615-1126. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Koller, John M can be contacted via phone (907) 486-6188.

Contact Information

Primary practice address
202 Center Ave. Ste. 102 Kodiak AK 99615-1126
Phone: (907) 486-6188
Fax: (907) 486-6146
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3737 Alaska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X S3737 Alaska

Profile Details

NPI number 1588721195
LBN Legal business name Koller, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Jan 10th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588721195 NPPES
Other K151630 MEDICARE ID ( DEACTIVATED AFTER 5.16.09)
MEDICAID MD10072 MEDICARE ID ( DEACTIVATED AFTER 5.16.09)
Other K162501 MEDICARE ID ( DEACTIVATED AFTER 5.16.09)

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