1932434792 NPI number — JOSEPH E COPELAND M.D.

Table of content: JOSEPH E COPELAND M.D. (NPI 1932434792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932434792 NPI number — JOSEPH E COPELAND M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COPELAND
Provider First Name:
JOSEPH
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932434792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14350 PAUL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SARATOGA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95070-5821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-740-8240
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MANIILAQ HEALH CENTER
Provider Second Line Business Practice Location Address:
BOX 43
Provider Business Practice Location Address City Name:
KOTZEBUE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-442-7387
Provider Business Practice Location Address Fax Number:
907-442-7250
Provider Enumeration Date:
10/13/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD60107134 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)