Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Koehl, PA

Individual provider Physician Assistant · NPI 1780564435

Mark Koehl, PA is a Physician Assistant in Fort Wayne, Indiana. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone: (260) 748-3650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1780564435
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 4, 2025
Last updated in NPPESSeptember 4, 2025
Certification dateAugust 11, 2025
Mailing address1721 Magnavox Way Ste B, Fort Wayne, IN 46804-1537

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