Individual
DR. MONICA CAROLINA KOPLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21084
MS
2085R0202X
Diagnostic Radiology Physician
57.009693
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179448
—
AL
01
—
P00846649
RAILROAD MEDICARE
—
01
—
P01194859
RAILROAD MEDICARE PTAN
MS
Enumeration date
05/02/2008
Last updated
02/03/2016
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