Individual
ROBERT WALTER KOCH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 W POPLAR AVE, COLLIERVILLE, TN 38017-0601
(901) 861-9000
Mailing address
1319 SMITHSON TRL, EADS, TN 38028-6902
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16195
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125950
—
MS
05
—
3020046
—
TN
Enumeration date
06/06/2006
Last updated
07/08/2007
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