Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | 51414 | TN |
Y | 2080P0204X | Pediatric Emergency Doctor | 53695 | AZ |
NPI | 1306133574 |
---|---|
Provider Name | Dr. Cynthia R Copley |
First Address | Phoenix, AZ 85016 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 17/03/2018 |