Individual
JACK A KOPECHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4950
(614) 722-4966
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35051568
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0688395
—
OH
01
—
4074192
CGS - MEDICARE
OH
Enumeration date
08/24/2005
Last updated
03/12/2026
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