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General NPI Number Information
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NPI Number | 1164461802
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Entity Type | Individual
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Provider Name | JEFFREY ALLAN COPOLOFF DPM
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 12/20/2016
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Provider Practice Location Address
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Address Line | 3811 E BELL RD SUITE 309
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City | PHOENIX
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State | AZ
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Zip | 85032-2138
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Country | US
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Telephone | 480-420-0749
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Fax | 480-420-0732
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Provider Business Mailing Address
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Address Line | 3811 E BELL RD SUITE 309
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City | PHOENIX
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State | AZ
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Zip | 85032-2138
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Country | US
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Telephone | 480-420-0749
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Fax | 480-420-0732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0355
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License Number State | AZ
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