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Individual

KEVIN K KOFFEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3439 GRANITE CIR, TOLEDO, OH 43617-1161
(419) 843-7996
(419) 841-7725
Mailing address
3439 GRANITE CIR, TOLEDO, OH 43617-1161
(419) 843-7996
(419) 841-7725

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35045739K
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000581405
ANTHEM
01
00267
PARAMOUNT
05
0479781
OH
01
4037439
AETNA
01
P00659824
RAILROAD MEDICARE
Enumeration date
10/04/2005
Last updated
05/01/2012
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