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Individual

DAVID G KOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 WATERMAN WAY, TAVARES, FL 32778
(352) 742-8836
(352) 742-8829
Mailing address
1737 DAVID WALKER DR, TAVARES, FL 32778-5745
(352) 742-8836
(352) 742-8829

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35075829
OH
207Q00000X
Family Medicine Physician
ME108164
FL
208M00000X
Hospitalist Physician
Primary
ME108164
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2161128
OH
Enumeration date
06/18/2005
Last updated
07/18/2018
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