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Organization
PEACHWOOD MEDICAL GROUP CLOVIS INC
Active
Organization
PEACHWOOD MEDICAL GROUP CLOVIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE ROY COPELAND M.D. (PRESIDENT)
(559) 324-6200
Entity
Organization
Contact information
Practice address
275 W HERNDON AVE, CLOVIS, CA 93612-0204
(559) 324-6200
(559) 324-6280
Mailing address
275 W HERNDON AVE, CLOVIS, CA 93612-0204
(559) 324-6200
(559) 324-6280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066590
—
CA
Enumeration date
11/08/2005
Last updated
03/23/2010
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