Copeland, Jerrelle M

Copeland, Jerrelle M is an individual health care provider with primary practice located at 6788 S Kings Ranch Rd Ste 1 , Gold Canyon AZ 85118-2928. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Copeland, Jerrelle M can be contacted via phone (480) 626-4999.

Contact Information

Primary practice address
6788 S Kings Ranch Rd Ste 1 Gold Canyon AZ 85118-2928
Phone: (480) 626-4999
Fax: (480) 304-3239
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25933 Arizona

Profile Details

NPI number 1790784643
LBN Legal business name Copeland, Jerrelle M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Mar 28th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790784643 NPPES
Arizona MEDICAID 404723

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