Individual
DR. JUSTIN LEE COPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
104 W MAIN ST, ANDERSON, MO 64831
(417) 845-6984
Mailing address
104 W MAIN ST, ANDERSON, MO 64831
(417) 845-6984
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024023340
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016026086
NURSING LICENSE
MO
01
—
2024023340
APRN NURSING LICENSE
MO
Enumeration date
06/15/2022
Last updated
06/27/2024
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