Organization
THOMAS K KOITHAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KIRBY KOITHAN D.O. (PRESIDENT)
(515) 883-0783
Entity
Organization
Contact information
Practice address
495 S 51ST ST UNIT 40, WEST DES MOINES, IA 50265-6988
(515) 883-0783
Mailing address
495 S 51ST ST UNIT 40, WEST DES MOINES, IA 50265-6988
(515) 883-0783
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
02799
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106294
—
IA
01
—
1235194143
INDIVDUAL NPI
IA
05
—
I4144
—
IA
Enumeration date
07/29/2009
Last updated
07/29/2009
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