Copeland, Charles Lee

Copeland, Charles Lee is an individual health care provider with primary practice located at 7900 W Jefferson Blvd Suite 304, Fort Wayne IN 46804-4128. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Copeland, Charles Lee can be contacted via phone (260) 969-6200.

Contact Information

Primary practice address
7900 W Jefferson Blvd Suite 304 Fort Wayne IN 46804-4128
Phone: (260) 969-6200
Fax: (260) 969-6201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Indiana

Profile Details

NPI number 1336460161
LBN Legal business name Copeland, Charles Lee
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2010
Last updated Aug 30th, 2012 - about 14 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 1336460161 NPPES
Indiana Other 000000762052 ANTHEM

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