Individual
DR. RUDY E KOKICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 FAIRVIEW DRIVE, SUITE 110, FRANKLIN, VA 23851
(757) 562-5121
Mailing address
104 FAIRVIEW DRIVE, SUITE 110, FRANKLIN, VA 23851
(757) 562-5121
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101040305
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045498
ANTHEM
VA
05
—
890542E
—
NC
Enumeration date
12/07/2006
Last updated
07/08/2007
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