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General NPI Number Information
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NPI Number | 1083822563
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Entity Type | Individual
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Provider Name | RANDY TRUMAN KOHL MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FOLSOM AND W. PROSPECTOR PLACE
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City | LINCOLN
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State | NE
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Zip | 68509-4661
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Country | US
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Telephone | 402-479-5931
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Fax | 402-478-5679
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Provider Business Mailing Address
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Address Line | 9030 PRINCETON ROAD
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City | FIRTH
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State | NE
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Zip | 68358
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Country | US
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Telephone | 402-791-2117
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Fax | 402-791-2132
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17022
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License Number State | NE
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