Healthcare Provider Details

I. General information

NPI: 1396126710
Provider Name (Legal Business Name): LYNNIECE A KOCHER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNNIECE A DUNBAR DO

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 N KENTUCKY AVENUE
EVANSVILLE IN
47722
US

IV. Provider business mailing address

PO BOX 1510
EVANSVILLE IN
47706-1510
US

V. Phone/Fax

Practice location:
  • Phone: 812-426-9565
  • Fax: 812-426-9572
Mailing address:
  • Phone: 812-426-9565
  • Fax: 812-426-9572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11018352A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02004919A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: