Provider Demographics
NPI:1225246564
Name:BRIAN KOPER,DO,LLC
Entity Type:Organization
Organization Name:BRIAN KOPER,DO,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-695-1304
Mailing Address - Street 1:1421 S POTOMAC ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4535
Mailing Address - Country:US
Mailing Address - Phone:303-695-1304
Mailing Address - Fax:303-534-0393
Practice Address - Street 1:1421 S POTOMAC ST
Practice Address - Street 2:SUITE 200
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4535
Practice Address - Country:US
Practice Address - Phone:303-695-1304
Practice Address - Fax:303-534-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45431174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty