Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | R3359 | TX |
N | 2086S0127X | Trauma Surgeon | MD429641 | PA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 245829 | MA |
NPI | 1245423367 |
---|---|
Provider Name | Dr. Jaromir Kohout |
First Address | Wilkes Barre, PA 18702-2600 |
Second Address | Houston, TX 77042-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
# 1031222150001 | (05) | PA |