Healthcare Provider Details

I. General information

NPI: 1376743138
Provider Name (Legal Business Name): BRIAN JOSEPH COPELAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 SAINT CHARLES AVE
NEW ORLEANS LA
70115-4637
US

IV. Provider business mailing address

1542 TULANE AVE RM 763
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-412-1517
  • Fax: 504-412-1518
Mailing address:
  • Phone: 504-568-4080
  • Fax: 504-568-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number201433
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number201433
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: