Individual
DAVID KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 HOSPITAL DRIVE, DC06910, COLUMBIA, MO 65212
(573) 882-1026
(573) 884-8524
Mailing address
1 HOSPITAL DRIVE, DC06910, COLUMBIA, MO 65212
(573) 882-1026
(573) 884-8524
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2016017560
MO
208600000X
Surgery Physician
2016017560
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016017560
MISSOURI BOARD OF HEALING ARTS
MO
Enumeration date
06/16/2016
Last updated
09/12/2019
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