RUSSELL DAVID KOESTERS PA NPI 1871161323

NPI Information

Russell David Koesters, PA is a surgical physician assistant in Johnson City, TN with 3 years of experience. Russell David Koesters, PA NPI is 1871161323. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2410 SUSANNAH ST
JOHNSON CITY, TN
ZIP 37601-748
Phone: (423) 282-9011
Fax: (423) 282-0035

The NPI 1871161323 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 6/11/2021 and was last updated on 6/11/2021.

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:

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