Copeland, Jack

Copeland, Jack is an individual health care provider with primary practice located at 200 W. Arbor Dr. Mc 8892, San Diego CA 92103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Copeland, Jack can be contacted via phone (619) 543-7777.

Contact Information

Primary practice address
200 W. Arbor Dr. Mc 8892 San Diego CA 92103
Phone: (619) 543-7777
Fax: (619) 543-2652
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 9927 Arizona

Profile Details

NPI number 1730152786
LBN Legal business name Copeland, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated May 31st, 2011 - about 15 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 1730152786 NPPES
Arizona Other 330002923 RR MEDICARE
Arizona MEDICAID 220997 RR MEDICARE

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