Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 35056253 | OH |
NPI | 1477595510 |
---|---|
Provider Name | Larry J Copeland |
First Address | Columbus, OH 43202-1559 |
Second Address | Hilliard, OH 43026-7752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 17/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0719253 | (05) | OH |
A17547 | (02) |