Provider Demographics
NPI:1780762195
Name:KOOPMAN, CHRISTIAN LEIGH (DO)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:LEIGH
Last Name:KOOPMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:940 N.E. 13TH ST
Mailing Address - Street 2:GARRISON TOWER, SUITE 4G4250, RADIOLOGICAL SCIENCES
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-271-5125
Mailing Address - Fax:
Practice Address - Street 1:940 N.E. 13TH ST
Practice Address - Street 2:GARRISON TOWER, SUITE 4G4250, RADIOLOGICAL SCIENCES
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-5125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology