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Individual

LUIS COPPELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
708 COEUR D'ALENE, PAYSON, AZ 85541
(928) 474-5259
(928) 472-8832
Mailing address
1010 N COUNTRY CLUB DR, MESA, AZ 85201-3309
(480) 461-2409

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9535
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
219726
AZ
Enumeration date
03/16/2006
Last updated
03/17/2008
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