Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | MD20530 | OR |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD20530 | OR |
NPI | 1093784902 |
---|---|
Provider Name | Dr. Paul S Koh |
First Address | Eugene, OR 97402-0451 |
Second Address | Springfield, OR 97477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 12/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269927 | (05) | OR |
I45448 | (02) |