Individual
DR. TIMOTHY GERRIT KOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1305 LEES CHAPEL RD., SUITE 101, GREENSBORO, NC 27455-2599
(336) 271-2020
(336) 275-8200
Mailing address
1305 LEES CHAPEL RD., SUITE 101, GREENSBORO, NC 27455-2599
(336) 271-2020
(336) 275-8200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC1666
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890927M
—
NC
Enumeration date
01/16/2007
Last updated
11/24/2008
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