| Thomas K Koithan Pc | |
|
495 S 51st St Unit 40 West Des Moines IA 50265-6988 | |
| (515) 883-0783 | |
| Not Available |
| Full Name | Thomas K Koithan Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 495 S 51st St Unit 40, West Des Moines, Iowa |
| Authorized Official Name and Position | Thomas Kirby Koithan (PRESIDENT) |
| Authorized Official Contact | 5158830783 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas K Koithan Pc 495 S 51st St Unit 40 West Des Moines IA 50265-6988 Ph: (515) 883-0783 | Thomas K Koithan Pc 495 S 51st St Unit 40 West Des Moines IA 50265-6988 Ph: (515) 883-0783 |
| NPI Number | 1821229519 |
|---|---|
| Provider Enumeration Date | 07/29/2009 |
| Last Update Date | 07/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821229519 | NPI | - | NPPES |
| I4144 | Medicaid | IA | |
| 1235194143 | Other | IA | INDIVDUAL NPI |
| 0106294 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 02799 (Iowa) | Primary |
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