Individual
DR. DAVID A KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
410 N HYATT ST, TIPP CITY, OH 45371-1434
(937) 667-6914
(937) 667-3744
Mailing address
410 N HYATT ST, TIPP CITY, OH 45371-1434
(937) 667-6914
(937) 667-3744
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T1099/3544
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000018967
ANTHEM
OH
Enumeration date
07/10/2006
Last updated
01/05/2009
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