Individual
DR. SAGE KINNEY COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
1218 13TH AVE SE, DECATUR, AL 35601-4307
(256) 355-6200
(256) 355-6241
Mailing address
1218 13TH AVE SE, DECATUR, AL 35601-4307
(256) 355-6200
(256) 355-6241
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
00011018
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000019326
—
AL
01
—
040011769
RAILROAD MEDICARE
AL
01
—
051019326
PROVIDER NUMBER
AL
01
—
510-19326
BCBS
AL
Enumeration date
11/08/2005
Last updated
01/28/2013
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