Doctor Name: | PETER RUBEN KOEHLER |
NPI Number: | 1659468601 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 151420-1205 |
Business Practice Address: | 50 N Medical Dr 1a71 Salt Lake City, UT - 841320001 |
Business Phone Number: | 8015817553 |
Business Fax Number: | |
Mailing Address: | Po Box 581200, SALT LAKE CITY |
State: | UT |
Postal Code: | 841581200 |
Phone Number: | 8012133800 |
Fax Number: | 8015853655 |
NPI Enumeration Date: | 10/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | 151420-1205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |