Individual
JACK ANDREW COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA, NM 87532-3456
(505) 986-8468
Mailing address
PO BOX 387, MARFA, TX 79843-0387
(432) 729-4608
(432) 729-4653
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
97-213
NM
Other
Enumeration date
02/09/2006
Last updated
01/25/2010
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