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Individual

JAMIE C KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
430 N MONTE VISTA ST, OK, ADA, OK 74820-4610
(580) 421-1160
(580) 332-5750
Mailing address
PO BOX 1386A, ADA, OK 74821-4913
(405) 200-7696
(580) 332-5750

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
26420
OK

Other

Enumeration date
06/11/2008
Last updated
06/14/2012
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