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NPI Code Detail

MEDICARE: ANTON KOOPMAN MD

MEDICARE:   ANTON  KOOPMAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician01037754AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080194069OTHERMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538182035
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTON KOOPMAN MD
Provider Business Mailing Address
First Line : PO BOX 775383
Second Line :
City : CHICAGO
State : IL
Zip : 60677-5383
Country : US
Telephone Number : 812-376-5315
Fax Number :
Provider Business Practice Location Address
First Line : 3581 CENTRAL AVENUE
Second Line :
City : COLUMBUS
State : IN
Zip : 47203-2036
Country : US
Telephone Number : 812-372-0137
Fax Number : 812-372-1304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 09/09/2024

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Directions to “ ANTON KOOPMAN MD” Practice Location

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