Ezra Koch, MD is a
General Practice physician based in Mandan, North Dakota. Ezra Koch is licensed to practice in North Dakota (license number 19404) and his current practice location is 4108 39th Ave Nw, Mandan, North Dakota. He can be reached at his office (for appointments etc.) via phone at
(701) 426-4291.
NPI number for Ezra Koch is 1861016024 and his current mailing address is 4108 39th Ave Nw, Mandan, North Dakota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1861016024.
Physician's Profile
| Full Name | Ezra Koch |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 4108 39th Ave Nw, Mandan, North Dakota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861016024
- Provider Enumeration Date: 06/03/2020
- Last Update Date: 03/01/2023
Medical Identifiers
Medical identifiers for Ezra Koch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861016024 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 19404 (North Dakota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ezra Koch is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ezra Koch, MD
4108 39th Ave Nw,
Mandan, ND 58554-1253
Ph: () - | Ezra Koch, MD
4108 39th Ave Nw,
Mandan, ND 58554-1253
Ph: (701) 426-4291 |
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