Individual
DR. TIFFANY TRUONG KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
7330 E 82ND ST, SUITE A, INDIANAPOLIS, IN 46256-1465
(317) 712-3708
(317) 712-3798
Mailing address
PO BOX 330, FORTVILLE, IN 46040-0330
(317) 863-2556
(317) 203-0420
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001245A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07001245A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005049
—
IN
Enumeration date
04/24/2014
Last updated
12/23/2024
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