| Paul Joseph Vandekoppel, MD | |
|
2651 E Discovery Pkwy, Bloomington, IN 47408-9059 | |
| (812) 353-9515 | |
| Not Available |
| Full Name | Paul Joseph Vandekoppel |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2651 E Discovery Pkwy, Bloomington, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487145298 | NPI | - | NPPES |
| 524640 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 52464 (South Carolina) | Secondary |
| 207P00000X | Emergency Medicine | 01088496A (Indiana) | Primary |
| Entity Name | Prisma Health-midlands |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205889458 PECOS PAC ID: 6800708330 Enrollment ID: O20031110000506 |
| Entity Name | Mcleod Health Cheraw |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275912974 PECOS PAC ID: 7911228259 Enrollment ID: O20151218002079 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Joseph Vandekoppel, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Paul Joseph Vandekoppel, MD 2651 E Discovery Pkwy, Bloomington, IN 47408-9059 Ph: (812) 353-9515 |
Ronald C Jenson, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4794 Red Oak Ln, Bloomington, IN 47401 Phone: 812-396-9620 | |
Dr. Robert Stone, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 514 W 2nd St, Bloomington, IN 47403 Phone: 812-353-3719 Fax: 812-353-3713 | |
Dr. Christina M Cabott, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 601 W 2nd St, Bloomington, IN 47403 Phone: 812-336-1690 Fax: 812-349-1325 | |
Otar Datiashvili, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-9515 Fax: 812-353-9275 | |
Dr. John Austin Lee, MD, MPH Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-9515 Fax: 812-353-9275 | |
Dr. Carlyle George Langhorn Jr., M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-9515 | |
Jonathan D Hart, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2605 E Creeks Edge Dr, Bloomington, IN 47401 Phone: 812-355-2300 Fax: 812-355-2316 |