Dr TRACEY KOPPERUD MD is a female medical professional, specializing in Obstetrics/gynecology. She graduated in 2002.
OB-GYN ASSOCIATES, PA
3101 E STATE ST
SUITE 2100
EAGLE
ID
836166232
Tel: 2089382220
| Npi | 1437194388 |
| Pac Id | 0648272872 |
| Professional Enrollment Id | I20121215000001 |
| Last Name | KOPPERUD |
| First Name | TRACEY |
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| Gender | F |
| Credential | MD |
| Medical School Name | OTHER |
| Graduation Year | 2002 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
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| Organization Legal Name | OB-GYN ASSOCIATES, PA |
| Group Practice Pac Id | 4082519467 |
| Number Of Group Practice Members | 11 |
| Line 1 Street Address | 3101 E STATE ST |
| Line 2 Street Address | SUITE 2100 |
| Marker Of Address Line 2 Suppression | |
| City | EAGLE |
| State | ID |
| Zip Code | 836166232 |
| Phone Number | 2089382220 |
| Hospital Affiliation Ccn 1 | 130006 |
| Hospital Affiliation Lbn 1 | ST LUKE'S REGIONAL MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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