Organization
FAMILY UROLOGY ASSOCIATES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN H. KOPCHICK M.D. (PRINCIPLE)
(616) 942-8868
Entity
Organization
Contact information
Practice address
1000 E PARIS AVE SE, SUITE 205, GRAND RAPIDS, MI 49546-3680
(616) 942-8868
(616) 942-8363
Mailing address
1000 E PARIS AVE SE, SUITE 205, GRAND RAPIDS, MI 49546-3680
(616) 942-8868
(616) 942-8363
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301043886
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1005357
MCLAREN HEALTH PLAN
MI
05
—
104135289
—
MI
01
—
3404100631
COMMUNITY CHOICE
MI
01
—
900002217
PRIORITY HEALTH
MI
Enumeration date
04/20/2007
Last updated
06/05/2008
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