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NPI Code Detail

MEDICARE: MICHAEL D. KOPLON M.D.

MEDICARE: MICHAEL D. KOPLON 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
1208M00000XHospitalist Physician34018TN
2207R00000XInternal Medicine PhysicianMD34018TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13149825OTHERTNBLUE CROSS BLUE SHIELD
21985645OTHERUNITED HEALTHCARE
37683058OTHERAETNA
48840602005OTHERCIGNA

General Provider Information

NPI Number : 1376546150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL D. KOPLON M.D.
Provider Business Mailing Address
First Line : P O BOX 1000 DEPT 351
Second Line :
City : MEMPHIS
State : TN
Zip : 38148-0001
Country : US
Telephone Number : 901-758-9900
Fax Number : 901-752-2335
Provider Business Practice Location Address
First Line : 1265 UNION AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3415
Country : US
Telephone Number : 901-516-2362
Fax Number : 901-516-8254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 05/01/2018

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