Organization Name: | COPELAND CARE |
NPI Number: | 1710314679 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DUAN C COPELAND (PRESIDENT) |
Mailing Address: | 2601 N 3rd St Suite 213 Phoenix |
State: | AZ US |
Postal Code: | 850041104 |
Phone Number: | 6025554986 |
Fax Number: | 4802482732 |
NPI Enumeration Date: | 10/08/2013 |
NPI Last Update Date: | 08/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 35699 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |