Individual
JUSTIN THOMAS KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1001 S GEORGE ST, YORK, PA 17403-3676
(717) 851-2450
(717) 851-3469
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-2450
(717) 851-3469
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H74630
MD
207P00000X
Emergency Medicine Physician
Primary
OS016603
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102838415
—
PA
01
—
2899302
HIGHMARK BLUE SHIELD
PA
Enumeration date
04/20/2010
Last updated
05/19/2022
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