Coppock, Larry Ray

Coppock, Larry Ray is an individual health care provider with primary practice located at 3601 N May Ave Suite C, Oklahoma City OK 73112-6641. He recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Technician, Other, Technologists, Technicians & Other Technical Service Providers / Perfusionist. Technologists, Technicians & Other Technical Service Providers / Perfusionist is his primary health care specialty. Coppock, Larry Ray can be contacted via phone (405) 604-5613.

Contact Information

Primary practice address
3601 N May Ave Suite C Oklahoma City OK 73112-6641
Phone: (405) 604-5613
Fax: (405) 601-3750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X LP7 Oklahoma
Technologists, Technicians & Other Technical Service Providers / Perfusionist 242T00000X LP7 Oklahoma

Profile Details

NPI number 1649334863
LBN Legal business name Coppock, Larry Ray
Credentials CCP LP RN
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Aug 24th, 2011 - about 13 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 1649334863 NPPES
Other 731213482002 BCBS
Other 5993501 BCBS

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