Individual
ILEY SCOTT COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
520 S EAGLE RD STE 1234, MERIDIAN, ID 83642-6355
(208) 429-0300
(208) 429-0305
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7871978
ID
363A00000X
Physician Assistant
MED-PAC-LIC-100093
MT
363A00000X
Physician Assistant
PA60870353
WA
Other
Enumeration date
07/03/2018
Last updated
04/06/2026
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