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Individual

PAUL Y KO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 630-7276
(317) 656-4216
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01082507A
IN
207P00000X
Emergency Medicine Physician
247728
NY
207P00000X
Emergency Medicine Physician
MD425126
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001292312
ANTHEM PTAN
IN
05
0108260
NJ
05
03012686
NY
05
101664714
PA
05
300027718
IN
01
M120064002
MEDICARE
IN
05
M120064002
IN
Enumeration date
07/10/2006
Last updated
02/24/2025
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