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Organization
COPE MEDICAL GROUP LLC
Active
Organization
COPE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO JOHNSON X MS, MST, MPH (CEO/OWNER)
(225) 772-4677
Entity
Organization
Contact information
Practice address
4242 HIGHWAY 19 STE B-3, ZACHARY, LA 70791-3982
(225) 772-4677
Mailing address
4242 HIGHWAY 19 STE B-3, ZACHARY, LA 70791-3982
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/16/2017
Last updated
06/16/2018
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