Individual ProviderDavid KochRadiologyAllopathic & Osteopathic PhysiciansPractice Address1 Hospital Drive, Dc06910, Columbia, MO 65212(573) 882-1026PECOS EnrollmentBased on the most recent information from CMS, provider David Koch is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1508216920Provider TypeIndividualFull NameKoch, DavidCredentialDOGenderMaleSole ProprietorYesEnumeration Date6/16/2016Last Updated9/12/2019Contact InformationPractice LocationPractice Address1 Hospital Drive, Dc06910, Columbia, MO 65212Phone(573) 882-1026Fax(573) 884-8524Mailing LocationMailing Address1 Hospital Drive, Dc06910, Columbia, MO 65212Phone(573) 882-1026Fax(573) 884-8524Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense2016017560MissouriCode208600000XDescriptionSurgeryAllopathic & Osteopathic PhysiciansLicense2016017560MissouriProvider IdentifiersIDDescriptionIssuerID2016017560DescriptionOtherIssuerMISSOURI BOARD OF HEALING ARTSMissouri