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NPI Code Detail

MEDICARE: GERARD COULON MD

MEDICARE: GERARD COULON 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
1208D00000XGeneral Practice Physician04-19528KS

Other Identifiers

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

General Provider Information

NPI Number : 1073597225
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARD COULON MD
Provider Business Mailing Address
First Line : 6725 SW 29TH ST
Second Line :
City : TOPEKA
State : KS
Zip : 66614-5625
Country : US
Telephone Number : 785-354-0517
Fax Number : 785-478-1508
Provider Business Practice Location Address
First Line : 6725 SW 29TH ST
Second Line :
City : TOPEKA
State : KS
Zip : 66614-5625
Country : US
Telephone Number : 785-354-0517
Fax Number : 785-478-1508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 01/31/2017

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