Individual
RICHARD TERRY COPPOLETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4320 MORSAY DR, ROCKFORD, IL 61107-4877
(815) 399-7000
(815) 399-7061
Mailing address
4320 MORSAY DR, ROCKFORD, IL 61107-4877
(815) 399-7000
(815) 399-7061
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036063584
IL
207W00000X
Ophthalmology Physician
G22942
CA
Other
Enumeration date
05/23/2006
Last updated
07/01/2010
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