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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 months 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 1972798049 NPPES
Indiana MEDICAID 201114320A
Indiana MEDICAID 036-132543
Indiana Other 000000777934
Indiana MEDICAID 7100213750

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