Provider Demographics
NPI:1780007427
Name:KOCH, JULIANNE (OD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:KOCH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2206
Mailing Address - Country:US
Mailing Address - Phone:479-806-6688
Mailing Address - Fax:
Practice Address - Street 1:1801 W END AVE STE 1150
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2528
Practice Address - Country:US
Practice Address - Phone:615-321-8881
Practice Address - Fax:615-321-8874
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2706152W00000X
TN3272152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management