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NPI Code Detail

MEDICARE: THOMAS KOCH MD

MEDICARE: THOMAS KOCH 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
1207R00000XInternal Medicine PhysicianNARI

General Provider Information

NPI Number : 1417873662
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS KOCH MD
Provider Business Mailing Address
First Line : 508 GRAND ARMY HWY APT 201
Second Line :
City : SOMERSET
State : MA
Zip : 02726-1229
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 825 CHALKSTONE AVE
Second Line :
City : PROVIDENCE
State : RI
Zip : 02908-4728
Country : US
Telephone Number : 401-456-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2026
Last Update Date : 06/29/2026

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