MEDICARE: JUSTIN D KOCHER R.D. L.D.

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
1	133V00000X	Registered Dietitian	DT07532	TX

General Provider Information

NPI Number	:	1194909135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN D KOCHER R.D. L.D.

Provider Business Mailing Address
First Line	:	1 JARRETT WHITE RD
Second Line	:
City	:	TRIPLER ARMY MEDICAL CENTER
State	:	HI
Zip	:	96859-5001
Country	:	US
Telephone Number	:	808-433-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	36000 DARNALL LOOP
Second Line	:	CARL R. DARNALL ARMY MEDICAL CENTER
City	:	FORT HOOD
State	:	TX
Zip	:	76554
Country	:	US
Telephone Number	:	254-288-8870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	04/11/2024

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