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Individual

MR. GARY SYDNEY KOECH III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-2000
Mailing address
1339 N CROSSING DR NE, ATLANTA, GA 30329-3570
(304) 813-9399

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN-NP292038
GA
363LA2100X
Acute Care Nurse Practitioner
RN292038
GA

Other

Enumeration date
12/02/2019
Last updated
10/13/2025
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