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General NPI Number Information
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NPI Number | 1861642175
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Entity Type | Organization
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Legal Business Name | JOAN M KOEWLER DPM PA
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 4157 CLARK RD
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City | SARASOTA
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State | FL
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Zip | 34233-2403
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Country | US
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Telephone | 941-923-4999
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Fax | 941-923-4998
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Provider Business Mailing Address
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Address Line | 4157 CLARK RD
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City | SARASOTA
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State | FL
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Zip | 34233-2403
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Country | US
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Telephone | 941-923-4999
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Fax | 941-923-4998
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JUDY E SMITH
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Credential |
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Telephone | 941-923-4999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO1696
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License Number State | FL
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