Provider Demographics
NPI:1013902238
Name:WILLIAM C KOHLER MD PA
Entity Type:Organization
Organization Name:WILLIAM C KOHLER MD PA
Other - Org Name:WILLIAM C KOHLER MD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:WILLIAM C KOHLER MD PA
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:352-683-7885
Mailing Address - Street 1:4075 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2467
Mailing Address - Country:US
Mailing Address - Phone:352-683-7885
Mailing Address - Fax:352-683-7877
Practice Address - Street 1:4075 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2467
Practice Address - Country:US
Practice Address - Phone:352-683-7885
Practice Address - Fax:352-683-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL145332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50265Medicare UPIN
FL01948AMedicare PIN