Individual
JUDITH A KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 HENRY ST, NORTH VERNON, IN 47265-1030
(812) 352-4300
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01050901
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185690
ANTHEM BCBS
IN
01
—
110217019
MEDICARE RAILROAD
—
05
—
200321600A
—
IN
01
—
2439556000
PASSPORT ADVANTAGE
KY
01
—
410053P
SIHO
IN
05
—
64033731
—
KY
01
—
7781222
AETNA
—
Enumeration date
06/28/2006
Last updated
08/29/2016
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