Healthcare Provider Details

I. General information

NPI: 1528062585
Provider Name (Legal Business Name): CHRISTOPHER S COPLEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 SLATE CREEK RD
GRUNDY VA
24614-6974
US

IV. Provider business mailing address

100 15TH ST NW
NORTON VA
24273-1616
US

V. Phone/Fax

Practice location:
  • Phone: 276-935-1000
  • Fax:
Mailing address:
  • Phone: 276-679-3488
  • Fax: 276-679-1500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0102204762
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0116027596
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: