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Individual

DR. WILLIAM JOSEPH KOPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2101 JACKSON ST, SUITE #208, ANDERSON, IN 46016-4388
(765) 646-8448
(765) 683-3130
Mailing address
2101 JACKSON ST, SUITE #208, ANDERSON, IN 46016-4388
(765) 646-8448
(765) 683-3130

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028142
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000084851
BLUE CROSS-BLUE SHIELD
IN
01
021761912
MEDICARE RAILROAD
IN
05
1001711230A
IN
01
5986267
AETNA
IN
01
7885580002
CIGNA
IN
Enumeration date
01/23/2006
Last updated
12/29/2009
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