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Individual

DR. STACEY ELLEN COPELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 629-3400
(573) 629-3414
Mailing address
6500 HOSPITAL DR STE 2A, HANNIBAL, MO 63401-6890
(573) 629-3400
(573) 629-3414

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2017033858
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7300007000
WV
01
P02146838
RAILROAD MEDICARE
MO
Enumeration date
09/21/2006
Last updated
09/22/2022
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