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DR. MARK THOMAS KOEHL M.D. NPI 1053399220


NPI Information

NPI: 1053399220
Provider Name: DR. MARK THOMAS KOEHL, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
8765 LEWIS AVE
TEMPERANCE, MI
ZIP 48182
Phone: (734) 847-3802
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DR. Mark Thomas Koehl, M.D. is a family medicine in Temperance, MI with 37 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Mark Thomas Koehl, M.D. NPI is 1053399220. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL COLLEGE OF OHIO
Graduation Year:1987

The provider's business location address is:

8765 LEWIS AVE
TEMPERANCE, MI
ZIP 48182-583
Phone: (734) 847-3802
Fax: (734) 847-3418

The NPI 1053399220 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 3/5/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine4301055332MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D33231MEDICARE UPINMICHIGAN
202214OTHERMICHIGANPARAMOUNT HEALTH CARE
3700E86031OTHERMICHIGANBCBS OF MICHIGAN
405816OTHERMICHIGANHEALTH PLAN OF MICHIGAN
5E86031004MEDICARE PINMICHIGAN
69310221MEDICARE PINOHIO
72047421MEDICAIDOHIO
8231807MEDICARE OSCAR/CERTIFICATIONWISCONSIN
92652573MEDICAIDMICHIGAN
104024381MEDICARE PINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.