Individual
DR. DANIEL JAMES KOCH
Active
Individual
DR. DANIEL JAMES KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1226
CO
152W00000X
Optometrist
Primary
3759T520
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000134652
ANTHEM BC PROVIDER ID #
OH
05
—
0821114
—
OH
01
—
1325654
WORKERS' COMP. RISK #
OH
01
—
34-1585183
FEDERAL TAX ID #
OH
01
—
34-1585183-00
BWC PROVIDER NUMBER
OH
01
—
4628497
AETNA PROVIDER ID #
OH
Enumeration date
11/16/2006
Last updated
09/05/2013
Update your record
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