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Contact Information

PETER C KOEPP, PA-C
2817 REILLY ST
FORT BRAGG, NC28310-7324
 Phone: 910-396-7775
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for PETER C KOEPP · (Male)

NPI Number 1497867907
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/31/2006
Last updated 06/09/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-02309
  • TX License # PA05201
  • TX Medicaid 186438101
  • TX Other 8Y0987 BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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