Individual
JEROEN RAYMOND COPPENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-8849
(314) 268-5061
Mailing address
3691 RUTGER ST, PROVIDER ENROLLEMENT, SAINT LOUIS, MO 63110-2515
(314) 977-4440
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2008012492
MO
Other
Enumeration date
09/25/2007
Last updated
03/26/2021
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