Provider Demographics
NPI:1144677618
Name:KOEHN, CHRISTOPHER DOUGLAS (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DOUGLAS
Last Name:KOEHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 S FREMONT AVE STE 3300
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2246
Mailing Address - Country:US
Mailing Address - Phone:417-820-5200
Mailing Address - Fax:417-820-5220
Practice Address - Street 1:2115 S FREMONT AVE STE 3300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2246
Practice Address - Country:US
Practice Address - Phone:417-820-5200
Practice Address - Fax:417-820-5220
Is Sole Proprietor?:No
Enumeration Date:2016-05-15
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10489207R00000X
MO2022031379207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine