Individual
ANTON KOOPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3581 CENTRAL AVENUE, COLUMBUS, IN 47203-2036
(812) 372-0137
(812) 372-1304
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037754A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080194069
MEDICARE RAILROAD
—
05
—
100176320A
—
IN
Enumeration date
07/25/2006
Last updated
09/09/2024
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