Individual
DR. RONALD PAUL KOEPKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2516 BROADMOOR BLVD, MONROE, LA 71201-2988
(318) 322-1161
(318) 322-9313
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
012929
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012929
LOUISIANA GROUP
LA
01
—
100471
VANTAGE HEALTH PLAN, INC
LA
05
—
1191469
—
LA
Enumeration date
03/09/2006
Last updated
09/12/2016
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