Organization
JAMES DAVID KOEPSELL MD SC
Active
Organization
JAMES DAVID KOEPSELL MD SC
Active
Other names
James D Koepsell MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY E KITTLE-KRAUS (OFFICE MANAGER)
(815) 962-0633
Entity
Organization
Contact information
Practice address
2829 GLENWOOD AVE, ROCKFORD, IL 61101-3542
(815) 962-0633
(815) 962-0142
Mailing address
2829 GLENWOOD AVE, ROCKFORD, IL 61101-3542
(815) 962-0633
(815) 962-0142
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831391424
GROUP
IL
Enumeration date
06/05/2007
Last updated
12/31/2008
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