DR. DAVID L KOPPEIN JR. (NPI# 1790988319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790988319 |
| Entity Type | Individual |
| Full Name | DR. DAVID L KOPPEIN JR. |
| Credential | NP |
| Practice Address |
1103 College Dr Mena AR 71953-2519 |
| Mailing Address |
10000 W Innovation Dr Milwaukee WI 53226-4837 |
| Practice Telephone | 4793941414 |
| Practice Fax Number | 4794373786 |
| Mailing Telephone | (414) 456-5006 |
| Mailing Fax Number | 4144566259 |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2017-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A004598 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
3167-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1103 COLLEGE DR |
| City | MENA |
| State | AR |
| Zip Code | 71953-2519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053525014 | Richard E. Eccles | Internal Medicine | 1103 College Dr, Mena, AR 71953-2519 | 2007-05-09 |
| 1235776311 | Hailee Elizabeth Rutherford | Family Medicine | 1103 College Dr, Mena, AR 71953-2519 | 2019-12-08 |
| 1598322810 | Mena Hospital Commission | Family Medicine | 1103 College Dr, Mena, AR 71953-2519 | 2019-05-22 |
| 1003473463 | Mena Hospital Commission | Pediatrics | 1103 College Dr, Mena, AR 71953-2519 | 2019-05-21 |
| 1346789724 | Jennifer Smith Kesterson | Nurse Practitioner | 1103 College Dr, Mena, AR 71953-2519 | 2017-02-17 |
| 1316493307 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 1103 College Dr, Mena, AR 71953-2519 | 2016-08-30 |
| 1699096297 | Walk In Center | General Practice | 1103 College Dr, Mena, AR 71953-2519 | 2010-06-17 |
| 1447571047 | Mena Family Health Center | Family Medicine | 1103 College Dr, Mena, AR 71953-2519 | 2010-06-17 |
| 1194921635 | Steven P Forrest | Family Medicine | 1103 College Dr, Mena, AR 71953-2519 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174166623 | Joshua Daniel Sirkis | Physical Therapist | 500 Crestwood Circle Suite G, Mena, AR 71953 | 2019-10-28 |
| 1841639960 | Village Apothecary, Inc. | Durable Medical Equipment & Medical Supplies | 134 S George, Mt Ida, AR 71953 | 2013-06-21 |
| 1922326586 | Boone Home Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 803-a Highway 71 North, Mena, AR 71953 | 2010-05-06 |
| 1841529112 | Chad Hill | Hearing Instrument Specialist | 601 W Hwy 71 N, Mena, AR 71953 | 2009-12-16 |
| 1467612085 | Kent Allen Schnetzler | Orthopaedic Surgery | 400 Crestwood Circle, Suite L, Mena, AR 71953 | 2008-06-17 |
| 1710101548 | Family Dentistry | Dentist | 701 C 7th Street, Mena, AR 71953 | 2007-04-12 |
| 1629291455 | Jennifer Rowland | Occupational Therapist | 1801 Hamilton Avenue, Mena, AR 71953 | 2007-04-10 |
| 1093886822 | Alina Mielnick | Urology | 601 Bd Hwy 71 N, Mena, AR 71953 | 2006-11-13 |
| 1821195256 | Robert Martin Cohen | Psychiatry & Neurology | 311 North Morrow Street, Mena, AR 71953 | 2006-09-20 |
| 1730284357 | Sidney H Simpson | Chiropractor | 1402-b Hwy 71 S, Mena, AR 71953 | 2006-09-14 |
| Find all providers in zip 71953 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992804447 | Sue Asher | Nurse Practitioner | 1201 Mena St, Mena, AR 71953-4280 | 2006-09-21 |
| 1689228975 | Anna Marie Davis | Nurse Practitioner | 1706 Highway 71 N, Mena, AR 71953-8917 | 2019-07-25 |
| 1720648702 | Samantha Jo Stovall | Nurse Practitioner | 136 Health Park Dr, Mena, AR 71953-9072 | 2019-06-20 |
| 1467979229 | Stacy Renee Scott | Nurse Practitioner | 311 Morrow St N, Mena, AR 71953-2516 | 2017-08-23 |
| 1346789724 | Jennifer Smith Kesterson | Nurse Practitioner | 1103 College Dr, Mena, AR 71953-2519 | 2017-02-17 |
| 1437578747 | Kara Danielle Tedford | Nurse Practitioner | 136 Health Park Dr, Mena, AR 71953-9072 | 2014-04-15 |
| 1366702987 | Sandra Sue Armstrong | Nurse Practitioner | 136 Health Park Dr, Mena, AR 71953-9072 | 2012-05-17 |
| 1659641496 | James Robert Mcwilliams | Nurse Practitioner | 136 Health Park Dr, Mena, AR 71953-9072 | 2012-01-11 |
| 1134425705 | Gretchen Laurel Goodnight | Nurse Practitioner | 1102 Crestwood Cir, Mena, AR 71953-5513 | 2011-01-31 |
| 1285805358 | Debra Inevia Fairless | Nurse Practitioner | 1210 Dequeen St, Mena, AR 71953-4132 | 2008-03-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.