Individual
THOMAS R COPPOLA
Active
Individual
THOMAS R COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
04045
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001101368
ANTHEM
KY
01
—
230950
SIHO
KY
05
—
300007832
—
IN
05
—
7100487210
—
KY
01
—
K250100
MEDICARE
KY
Enumeration date
05/22/2012
Last updated
04/11/2024
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