Organization
COPPERFIELD OB/GYN P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL K GIBBY CPC (BUSINESS MANAGER)
(704) 786-7158
Entity
Organization
Contact information
Practice address
349 PENNY LN, CONCORD, NC 28025-1221
(704) 786-7158
(704) 786-7160
Mailing address
349 PENNY LN, CONCORD, NC 28025-1221
(704) 786-7158
(704) 786-7160
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104V
BCBS
NC
05
—
890104V
—
NC
Enumeration date
03/27/2006
Last updated
08/22/2020
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