Healthcare Provider Details

I. General information

NPI: 1932209871
Provider Name (Legal Business Name): IMBER COPPINGER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 E PARK DR STE 105C
ATHENS OH
45701-5003
US

IV. Provider business mailing address

416 COLEGATE DR BLDG 3
MARIETTA OH
45750-9549
US

V. Phone/Fax

Practice location:
  • Phone: 740-423-4015
  • Fax: 740-592-4010
Mailing address:
  • Phone: 740-374-3526
  • Fax: 740-374-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.007281
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: