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Individual

DR. JEFFREY A. COPPES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6502 GRAPE ROAD, SUITE 898, MISHAWAKA, IN 46545
(574) 277-7723
(574) 277-9698
Mailing address
6502 GRAPE ROAD, SUITE 898, MISHAWAKA, IN 46545
(574) 277-7723
(574) 277-9698

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002135A
IN
152W00000X
Optometrist
18002135B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000273033
BLUE CROSS ELKHART
IN
01
01172
SPECTERA ELKHART
IN
05
100414710
IN
01
2550910002
DMERC ELKHART
IN
01
351368448
VISION SERVICE PLAN
IN
01
IN2135
EYE MED ELKHART
IN
01
IN72135
VISIONBENEFITSAMERICA ELK
IN
Enumeration date
09/09/2005
Last updated
01/31/2013
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