Provider Demographics
NPI:1336324227
Name:KOELBEL, KLAUS FRIEDRICH (MD)
Entity Type:Individual
Prefix:
First Name:KLAUS
Middle Name:FRIEDRICH
Last Name:KOELBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7909 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-4057
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:504-894-2868
Practice Address - Street 1:7909 WILLOW ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-4057
Practice Address - Country:US
Practice Address - Phone:504-842-4000
Practice Address - Fax:504-894-2868
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201825207RH0002X
LAMD201825207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4N002OtherMEDICARE PIN
MS02671035Medicaid
LA1501921Medicaid
LA4N0027061Medicare PIN