Provider Demographics
NPI:1437688868
Name:KOPPLIN, ECHO L (DMSC, PA-C)
Entity Type:Individual
Prefix:DR
First Name:ECHO
Middle Name:L
Last Name:KOPPLIN
Suffix:
Gender:F
Credentials:DMSC, PA-C
Other - Prefix:MISS
Other - First Name:ECHO
Other - Middle Name:L
Other - Last Name:BARTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1810 DURGIN CT
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-8669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:135 PONDEROSA AVE
Practice Address - Street 2:
Practice Address - City:HILL CITY
Practice Address - State:SD
Practice Address - Zip Code:57745-6057
Practice Address - Country:US
Practice Address - Phone:605-394-2118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2134363A00000X
363A00000X
SD1441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty