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NPI Code Detail

MEDICARE: JOSEPH ANTHONY KOKE

MEDICARE: JOSEPH ANTHONY KOKE
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
1156FX1800XOptician
2156FX1800XOptician1101003962VA

General Provider Information

NPI Number : 1558139113
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH ANTHONY KOKE
Provider Business Mailing Address
First Line : 6400 MAIN ST
Second Line :
City : GLOUCESTER
State : VA
Zip : 23061-5511
Country : US
Telephone Number : 757-708-1294
Fax Number :
Provider Business Practice Location Address
First Line : 6819 WALTONS LN
Second Line :
City : GLOUCESTER
State : VA
Zip : 23061-6113
Country : US
Telephone Number : 804-693-2623
Fax Number : 804-693-8905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2023
Last Update Date : 12/13/2023

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