Organization
JULIAN DEBRUYNKOPS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN DE BRUYN KOPS MD (DIRECTOR)
(208) 522-6106
Entity
Organization
Contact information
Practice address
2065 E 17TH ST, SUITE C, IDAHO FALLS, ID 83404-8042
(208) 522-6106
Mailing address
2065 E 17TH ST, SUITE C, IDAHO FALLS, ID 83404-8042
(208) 522-6106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M3222
ID
Other
Enumeration date
09/16/2010
Last updated
11/19/2010
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