Individual
JAN O KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 N CENTER ST, HICKORY, NC 28601-5046
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 60359, CHARLOTTE, NC 28260-0359
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200000857
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126K2
BCBS
NC
05
—
89126K2
—
NC
Enumeration date
04/01/2006
Last updated
03/09/2009
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