Individual
DR. RANDOLPH LEIGH COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1256
Mailing address
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1256
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD.013119
LA
207XP3100X
Pediatric Orthopaedic Surgery Physician
025131
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E5728
—
NM
05
—
580218
—
AZ
Enumeration date
07/05/2006
Last updated
02/24/2014
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