=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013902238
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM C KOHLER MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2005
-----------------------------------------------------
Last Update Date | 04/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4075 MARINER BLVD
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34609-2467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-683-7885
-----------------------------------------------------
Fax | 352-683-7877
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4075 MARINER BLVD
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34609-2467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-683-7885
-----------------------------------------------------
Fax | 352-683-7877
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | WILLIAM C KOHLER MD PA
-----------------------------------------------------
Name | DR. WILLIAM C KOHLER
-----------------------------------------------------
Credential | MD PA
-----------------------------------------------------
Telephone | 352-683-7885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 14533
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------