Individual
DARRYL GLEN KOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N PICKAWAY ST, CIRCLEVILLE, OH 43113-2409
(740) 474-2126
(740) 477-1022
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35070336K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000316757
BCBS
OH
05
—
2055289
—
OH
01
—
P00120093
RR CIRCLEVILLE
—
Enumeration date
05/10/2006
Last updated
06/11/2008
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