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Individual

WARD BENTON COPPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
114 S 93RD ST, OMAHA, NE 68114-3944
(402) 397-9282
Mailing address
114 S 93RD ST, OMAHA, NE 68114-3944
(402) 397-9282

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11873
NE

Other

Enumeration date
06/05/2007
Last updated
07/08/2007
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