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NPI Code Detail

MEDICARE: DR. GREGG A COUP M.D.

MEDICARE:  DR. GREGG A COUP  M.D.
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 Physician30430KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000103684OTHERKSTRICARE
2103684OTHERKSBLUE CROSS BLUE SHIELD
3473350OTHERKSFIRST GUARD

General Provider Information

NPI Number : 1295722429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGG A COUP M.D.
Provider Business Mailing Address
First Line : 4000 CAMBRIDGE ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8501
Country : US
Telephone Number : 913-588-6504
Fax Number :
Provider Business Practice Location Address
First Line : 4000 CAMBRIDGE ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8501
Country : US
Telephone Number : 913-588-6504
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 03/01/2023

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Directions to “ DR. GREGG A COUP M.D.” Practice Location

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