Healthcare Provider Details

I. General information

NPI: 1629531553
Provider Name (Legal Business Name): RACHEL KOPKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 ATLANTA RD SE
SMYRNA GA
30080-6406
US

IV. Provider business mailing address

4441 ATLANTA RD SE
SMYRNA GA
30080-6406
US

V. Phone/Fax

Practice location:
  • Phone: 470-267-2493
  • Fax:
Mailing address:
  • Phone: 470-267-2493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number114249
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberNA
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: