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General NPI Number Information
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NPI Number | 1821818832
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Entity Type | Organization
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Legal Business Name | HOMEDOC, PC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2584 RESERVE ST
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City | ERIE
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State | CO
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Zip | 80516-2505
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Country | US
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Telephone | 970-391-4303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 479
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City | ERIE
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State | CO
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Zip | 80516-0479
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Country | US
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Telephone | 970-391-4303
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | DR. CHARLES SCOTT KOPEL
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Credential | MD
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Telephone | 970-391-4303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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