Individual
DR. KEVIN ANTHONY KOPKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 MEDICAL CENTER DRIVE, SUITE 115, FAYETTEVILLE, NY 13066
(315) 329-2555
Mailing address
4100 MEDICAL CENTER DRIVE, SUITE 115, FAYETTEVILLE, NY 13066
(315) 329-2555
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
272408
NY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
272408
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04704138
—
NY
Enumeration date
04/13/2010
Last updated
12/19/2025
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