Provider Demographics
NPI:1326124686
Name:KOCHIS, STEFAN MATTHEW (OD)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:MATTHEW
Last Name:KOCHIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 E WOODMEN RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-5257
Mailing Address - Country:US
Mailing Address - Phone:719-531-5566
Mailing Address - Fax:719-437-3460
Practice Address - Street 1:5550 E WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-5257
Practice Address - Country:US
Practice Address - Phone:719-531-5566
Practice Address - Fax:719-437-3460
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003518152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist