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General NPI Number Information
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NPI Number | 1639476252
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Entity Type | Organization
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Legal Business Name | KOPYTA INTERNAL MEDICINE, PC
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 312 SAND MTN DR SE
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City | ALBERTVILLE
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State | AL
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Zip | 35950-2330
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Country | US
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Telephone | 256-891-4577
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Fax | 256-891-4919
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Provider Business Mailing Address
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Address Line | 312 SAND MTN DR SE
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City | ALBERTVILLE
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State | AL
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Zip | 35950-2330
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Country | US
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Telephone | 256-891-4577
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Fax | 256-891-4919
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARBARA ELZBIETA KUCEWICZ-KOPYTA
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Credential | M.D.
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Telephone | 256-891-4577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 00021174
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License Number State | AL
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