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Organization

KOHLES FAMILY PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN K KOHLES MD (PROVIDER)
(765) 393-1488
Entity
Organization

Contact information

Practice address
1815 UNIVERSITY BLVD, ANDERSON, IN 46012-3164
(765) 393-1488
(765) 400-5217
Mailing address
1815 UNIVERSITY BLVD, ANDERSON, IN 46012-3164
(765) 393-1488
(765) 400-5217

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01040490
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300017273
IN
Enumeration date
04/04/2018
Last updated
11/26/2018
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