MARK KOEHL PA
NPI 1780564435
Physician Assistant in Fort Wayne, IN

Active since September 04, 2025
1721 MAGNAVOX WAY, FORT WAYNE, IN 46804(260) 748-3650 Get Directions Write a Review

NPPES record last updated: September 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mark Koehl Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK KOEHL PA (NPI 1780564435) is an individual physician assistant in Fort Wayne, Indiana and active in the NPI registry since September 2025.

NPPES Registry Identity

NPI1780564435
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMARK KOEHLCredential: PA
Location Address1721 MAGNAVOX WAYFort Wayne, IN 46804-1537
Mailing Address1721 Magnavox Way Ste BFort Wayne, IN 46804-1537 · (260) 748-3650 · Fax (260) 748-3651
Sole ProprietorNo
Enumeration DateSeptember 4, 2025
NPPES CertifiedAugust 11, 2025
NPI 1780564435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1721 MAGNAVOX WAY, Fort Wayne, IN 46804

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pain Medicine (Interventional Pain Medicine)
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Physician Assistant (Medical)
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Physical Medicine & Rehabilitation
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Physician Assistant
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Physician Assistant
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Physician Assistant
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Nurse Practitioner
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804
Anesthesiology
1721 MAGNAVOX WAY
FORT WAYNE, IN 46804

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Koehl's NPI number?

The NPI number for Mark Koehl is 1780564435. It was assigned to this individual provider in the NPPES registry on September 4, 2025.

Where is Mark Koehl located?

Mark Koehl practices at 1721 Magnavox Way, Fort Wayne, IN 46804. The listed phone number is (260) 748-3650.

What is Mark Koehl's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Mark Koehl was last updated on September 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.