Provider Demographics
NPI:1013941509
Name:KOCH, JAMES TOWNSLEY (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TOWNSLEY
Last Name:KOCH
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:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-0038
Mailing Address - Country:US
Mailing Address - Phone:515-465-4203
Mailing Address - Fax:515-465-5373
Practice Address - Street 1:1313 2ND ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-1511
Practice Address - Country:US
Practice Address - Phone:515-465-4203
Practice Address - Fax:515-465-5373
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA152 01801152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1166322Medicaid
IA4062166Medicaid
IA1062166Medicaid
IA0547170002OtherDMERC
IAP00204355OtherRAILROAD
IA29248Medicare PIN
IA29250Medicare PIN
IA4062166Medicaid
IA1062166Medicaid