Provider Demographics
NPI:1609295369
Name:KOEHLER, RYAN (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:KOEHLER
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 1:8200 DODGE STREET
Mailing Address - Street 2:ORTHOPAEDIC DIVISION
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-8774
Mailing Address - Country:US
Mailing Address - Phone:402-955-6300
Mailing Address - Fax:
Practice Address - Street 1:8200 DODGE STREET
Practice Address - Street 2:ORTHOPAEDIC DIVISION
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-8774
Practice Address - Country:US
Practice Address - Phone:402-955-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32585207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery