# MR. JEFFREY ALLAN COPOLOFF

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1164461802
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 0355 | AZ | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 12/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11178489 | CAQH | AZ |
| 01 | — | 113710768 | TRICARE | AZ |
| 05 | — | 129181 | — | AZ |
| 01 | — | 2Z1833 | HEALTH NET AZ | AZ |
| 01 | — | 4496171 | AETNA | AZ |
| 01 | — | 6202669 | GHI | AZ |
| 01 | — | 6624646 | CIGNA | AZ |
| 01 | — | AZ0195160 | BCBS | AZ |