Provider Demographics
NPI:1548333172
Name:KOEMETER-COX, CAROL SUSAN (PA-C)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:SUSAN
Last Name:KOEMETER-COX
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 APPLEDALE RD
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1702
Mailing Address - Country:US
Mailing Address - Phone:610-630-4894
Mailing Address - Fax:
Practice Address - Street 1:KNIGHTS RD AND RED LION RD
Practice Address - Street 2:FRANKFORD HEALTH CARE SYSTEM JEFFERSON HEALTH SYSTEM
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114
Practice Address - Country:US
Practice Address - Phone:215-612-4305
Practice Address - Fax:215-612-4817
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA001684L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical