Copeland, Jerrelle M
Copeland, Jerrelle M is an individual health care provider with primary practice located at 6788 S Kings Ranch Rd Ste 1 , Gold Canyon AZ 85118-2928. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Copeland, Jerrelle M can be contacted via phone (480) 626-4999.Contact Information
Primary practice address
6788 S Kings Ranch Rd Ste 1
Gold Canyon AZ 85118-2928
Phone: (480) 626-4999
Fax: (480) 304-3239
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25933 | Arizona |
Profile Details
| NPI number | 1790784643 |
|---|---|
| LBN Legal business name | Copeland, Jerrelle M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Mar 28th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790784643 | NPPES |
| Arizona | MEDICAID | 404723 |
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