Individual
SCOTT FRASER KOHLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 E HOUSTON ST STE 530, TYLER, TX 75702-8366
(903) 606-4300
Mailing address
1136 E GRANDE BLVD, TYLER, TX 75703-3982
(903) 592-5601
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
R5582
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1N9534
MEDICARE
TX
Enumeration date
03/02/2018
Last updated
10/25/2023
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