Individual
MR. RICHARD HENRY KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 SOUTH 4TH STREET, FULTON, NY 13069
(315) 592-3510
(315) 452-2510
Mailing address
2736 CHADSWORTH LANE, SOUTHPORT, NC 28461
(315) 440-5507
(315) 452-2510
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
144511
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02357486
—
NY
01
—
1073575023
BCBS
NY
05
—
1073575023
—
NY
Enumeration date
04/05/2006
Last updated
04/26/2013
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