Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 59461 | MN |
N | 111NI0900X | Internist | 59461 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | 59461 | MN |
Y | 207RI0011X | Interventional Cardiology | 59461 | MN |
NPI | 1023284288 |
---|---|
Provider Name | Louis Phillip Kohl III |
First Address | Minneapolis, MN 55415-1623 |
Second Address | Minneapolis, MN 55404-1210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 12/08/2020 |