Provider Demographics
NPI:1275590358
Name:KOECHNER, JOSEPH P (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:KOECHNER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AZTEC CT
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-1547
Mailing Address - Country:US
Mailing Address - Phone:785-742-2115
Mailing Address - Fax:
Practice Address - Street 1:101 S 6TH ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2306
Practice Address - Country:US
Practice Address - Phone:785-742-2125
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist