Joel Arthur Koeppen, | |
77 Windsor Way, Dallas, GA 30132-0577 | |
(470) 747-8447 | |
Not Available |
Full Name | Joel Arthur Koeppen |
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Gender | Male |
Speciality | Chiropractor |
Location | 77 Windsor Way, Dallas, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720562440 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CHIR010091 (Georgia) | Primary |
Provider Name | Anodyne Pain Group Of North Georgia Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1629701610 PECOS PAC ID: 9436530581 Enrollment ID: O20220720001810 |
Mailing Address | Practice Location Address |
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Joel Arthur Koeppen, 77 Windsor Way, Dallas, GA 30132-0577 Ph: (470) 747-8447 | Joel Arthur Koeppen, 77 Windsor Way, Dallas, GA 30132-0577 Ph: (470) 747-8447 |
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