Provider Demographics
NPI:1427021211
Name:KOPEC, ISABELLE (MD)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:KOPEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE CITYPLACE DRIVE
Mailing Address - Street 2:SUITE 570
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7067
Mailing Address - Country:US
Mailing Address - Phone:314-514-6000
Mailing Address - Fax:314-514-6020
Practice Address - Street 1:ONE CITYPLACE DRIVE
Practice Address - Street 2:SUITE 570
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7067
Practice Address - Country:US
Practice Address - Phone:314-514-6000
Practice Address - Fax:866-497-1239
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO102213207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208846402Medicaid
MO208846402Medicaid
MOF53358Medicare UPIN