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NPI Code Detail

MEDICARE: DEBRA M KOEPFER PA

MEDICARE: DEBRA M KOEPFER PA
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
1363AM0700XMedical Physician AssistantPA.0004453CO
2208000000XPediatrics PhysicianPA.0004453CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659599975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA M KOEPFER PA
Provider Business Mailing Address
First Line : 3205 N ACADEMY BLVD
Second Line : STE 130
City : COLORADO SPRINGS
State : CO
Zip : 80917-5147
Country : US
Telephone Number : 719-632-5700
Fax Number :
Provider Business Practice Location Address
First Line : 722 S WAHSATCH AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80903-4035
Country : US
Telephone Number : 719-632-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 04/04/2017

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Directions to “ DEBRA M KOEPFER PA” Practice Location

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