Individual
ROBERT EDWARD KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3125 DR RUSSELL SMITH WAY, CARTHAGE, MO 64836-7402
(417) 359-2653
(417) 358-4612
Mailing address
10917 GUM RD, CARTHAGE, MO 64836-9529
(417) 237-0588
(417) 237-0588
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
063623
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01158529
RAIL ROAD MEDICARE
MO
Enumeration date
02/01/2006
Last updated
02/18/2014
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