Koth, Kevin G.
Koth, Kevin G. is an sole proprietor health care provider with primary practice located at 12866 Troxler Ave , Highland IL 62249-2806. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Koth, Kevin G. can be contacted via phone (618) 900-1070.Contact Information
Primary practice address
12866 Troxler Ave
Highland IL 62249-2806
Phone: (618) 900-1070
Fax: (833) 992-2437
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 03476 | Kentucky |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 02003992A | Indiana |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 03476 | Kentucky |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 036132543 | Illinois |
Profile Details
| NPI number | 1972798049 |
|---|---|
| LBN Legal business name | Koth, Kevin G. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 11th, 2007 |
| Last updated | Mar 14th, 2024 - about 2 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 | 1972798049 | NPPES |
| Indiana | MEDICAID | 201114320A | |
| Indiana | MEDICAID | 036-132543 | |
| Indiana | Other | 000000777934 | |
| Indiana | MEDICAID | 7100213750 |
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