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Individual

DR. DANNY L COPELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6824 NEWBURG RD, ROCKFORD, IL 61108-4330
(779) 696-7610
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036051141
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036051141
IL
Enumeration date
06/12/2006
Last updated
02/05/2015
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