Gold Canyon Internal Medicine

LBN: Gold Canyon Internal Medicine
Gold Canyon Internal Medicine is an health care organization with primary practice located at 6724 S Kings Ranch Rd Ste 102 , Gold Canyon AZ 85118-2963. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Suppliers / Non-Pharmacy Dispensing Site. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Gold Canyon Internal Medicine can be contacted via phone (480) 626-4999, or through Copeland, Jerrelle M via phone (480) 370-2602.

Contact Information

Primary practice address
6724 S Kings Ranch Rd Ste 102 Gold Canyon AZ 85118-2963
Phone: (480) 626-4999
Fax: (480) 304-3239
Website:
Map and Directions
Authorized official contact:
Name: Copeland, Jerrelle M Doctor of Medicine (MD)
Phone: (480) 370-2602

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25933 Arizona
Suppliers / Non-Pharmacy Dispensing Site 332900000X Arizona

Profile Details

NPI number 1417112541
LBN Legal business name Gold Canyon Internal Medicine
DBA Doing business as
Authorized official Copeland, Jerrelle M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 29th, 2008
Last updated Jul 21st, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417112541 NPPES
Arizona MEDICAID 404723

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