MEDICARE: RANDY L KOCHEL 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
1	207Q00000X	Family Medicine Physician	MD035484E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00467179	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0117653	OTHER	PA	HIGHMARK BLUE SHIELD
2	0038359000	OTHER	PA	INDEPENDENCE BLUE CROSS
4	B37053	OTHER	PA	HEALTHAMERICA
5	39792 S1Q2	OTHER	PA	GEISINGER
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	50072505	OTHER	PA	CAPITAL BLUE CROSS
8	513732	OTHER	PA	AETNA
9	P004430	OTHER	PA	GATEWAY

General Provider Information

NPI Number	:	1558397646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDY L KOCHEL MD

Provider Business Mailing Address
First Line	:	5275 LINCOLN HWY
Second Line	:
City	:	GAP
State	:	PA
Zip	:	17527-9427
Country	:	US
Telephone Number	:	717-442-8111
Fax Number	:	717-442-8981

Provider Business Practice Location Address
First Line	:	5275 LINCOLN HWY
Second Line	:
City	:	GAP
State	:	PA
Zip	:	17527-9427
Country	:	US
Telephone Number	:	717-442-8111
Fax Number	:	717-442-8981

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	10/07/2009

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Directions to “ RANDY L KOCHEL MD” Practice Location

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