Coppock, Jeffrey Douglas

Coppock, Jeffrey Douglas is an sole proprietor health care provider with primary practice located at 200 Nw 4Th St , Bryant AR 72022-3424. He recently has 4 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Coppock, Jeffrey Douglas can be contacted via phone (501) 847-5660.

Contact Information

Primary practice address
200 Nw 4Th St Bryant AR 72022-3424
Phone: (501) 847-5660
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2660 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA2715 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X OTA936 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OTR825 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2370 Arkansas

Profile Details

NPI number 1841250198
LBN Legal business name Coppock, Jeffrey Douglas
Credentials MS PT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2006
Last updated Jul 31st, 2019 - about 5 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 1841250198 NPPES
Arkansas MEDICAID 211208721
Arkansas MEDICAID 139676721
Arkansas MEDICAID 1619411721
Arkansas MEDICAID 197090795
Arkansas MEDICAID 126978721
Arkansas MEDICAID 149815721
Arkansas Other 5U673

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