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Individual

DR. GEORGE ANTHONY KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2287
(573) 302-2241
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
2002021772
MO
208M00000X
Hospitalist Physician
Primary
2002021772
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
245978408
MO
01
P00171341
RAILROAD MEDICARE
MO
Enumeration date
07/20/2005
Last updated
05/01/2008
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