Individual
DR. JONATHAN KOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7370 TURFWAY RD, STE 390, FLORENCE, KY 41042
(859) 212-5125
(859) 212-5099
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 428-5770
(859) 428-5780
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
45549
KY
207V00000X
Obstetrics & Gynecology Physician
57.015507
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070053
—
OH
05
—
201164500
—
IN
05
—
7100206600
—
KY
01
—
P01103044
RR MEDICARE
KY
Enumeration date
05/26/2011
Last updated
09/14/2018
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