MEDICARE: JOHN J KOKEMOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	013811	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013917517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J KOKEMOR MD

Provider Business Mailing Address
First Line	:	2633 NAPOLEON AVE
Second Line	:	NEW ORLEANS
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6357
Country	:	US
Telephone Number	:	504-897-3305
Fax Number	:	504-897-3331

Provider Business Practice Location Address
First Line	:	2633 NAPOLEON AVE
Second Line	:	NEW ORLEANS
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6357
Country	:	US
Telephone Number	:	504-897-3305
Fax Number	:	504-897-3331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	01/12/2010

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Directions to “ JOHN J KOKEMOR MD” Practice Location

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