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Individual

STEVEN A. KOHTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
730 N COLLEGE RD, SUITE A, TWIN FALLS, ID 83301-3382
(208) 814-7300
(208) 933-4601
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M9762
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
808045500
ID
01
P00654625
MCRR
ID
Enumeration date
03/21/2007
Last updated
12/29/2014
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