Koepsell, James David

Koepsell, James David is an sole proprietor health care provider with primary practice located at 2829 Glenwood Ave , Rockford IL 61101-3542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Koepsell, James David can be contacted via phone (815) 962-0633.

Contact Information

Primary practice address
2829 Glenwood Ave Rockford IL 61101-3542
Phone: (815) 962-0633
Fax: (815) 962-0142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 036077059 Illinois

Profile Details

NPI number 1285675967
LBN Legal business name Koepsell, James David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2006
Last updated Aug 31st, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285675967 NPPES
Illinois MEDICAID 036077059

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