Individual
DR. TERESA KOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 W 18TH ST, COVINGTON, KY 41011-3329
(859) 757-0717
(859) 331-2425
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 757-0717
(859) 331-2425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01089207A
IN
207Q00000X
Family Medicine Physician
31695
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
01089207A
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
31695
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080142307
RAILROAD MEDICARE
KY
05
—
2275274
—
OH
05
—
64316953
—
KY
01
—
P00856609
RAILROAD MEDICARE
KY
Enumeration date
06/04/2006
Last updated
11/21/2025
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