Healthcare Provider Details

I. General information

NPI: 1225084627
Provider Name (Legal Business Name): JEFFREY A. COPOLOFF, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 N PIMA RD SUITE 100
SCOTTSDALE AZ
85258-4480
US

IV. Provider business mailing address

PO BOX 14390
SCOTTSDALE AZ
85267-4390
US

V. Phone/Fax

Practice location:
  • Phone: 623-934-3211
  • Fax: 480-661-3990
Mailing address:
  • Phone: 623-934-3211
  • Fax: 480-661-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0355
License Number StateAZ

VIII. Authorized Official

Name: DR. JEFFREY A COPOLOFF
Title or Position: OWNER/DOCTOR
Credential: DPM
Phone: 623-934-3211