1093743551 NPI number — DR. MARGARET A COPLIN M.D.

Table of content: DR. MARGARET A COPLIN M.D. (NPI 1093743551)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093743551 NPI number — DR. MARGARET A COPLIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COPLIN
Provider First Name:
MARGARET
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093743551
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
450 N NEW BALLAS RD
Provider Second Line Business Mailing Address:
SUITE 270
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63141-6835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-989-1300
Provider Business Mailing Address Fax Number:
314-989-1323

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSAGE BEACH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-302-2772
Provider Business Practice Location Address Fax Number:
573-302-2884
Provider Enumeration Date:
06/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133N00000X , with the licence number:  2000156446 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 2000156446 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: 2000156446 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 209222801 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".