# TODD LANE KOOY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104938208
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | 04-36314 | KS | — |
| 2085R0202X | Diagnostic Radiology Physician | 26523 | NE | — |
| 2085R0202X | Diagnostic Radiology Physician | 50665 | CO | — |
| 2085R0202X | Diagnostic Radiology Physician | MD17508 | HI | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | DR.0050665 | CO | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | MD00046721 | WA | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 03/29/2024