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NPI Code Detail

MEDICARE: MATTHEW DUANE COPPLE D.O.

MEDICARE:   MATTHEW DUANE COPPLE  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianDO.000290LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11992983092OTHERLAGROUP NPI

General Provider Information

NPI Number : 1033315742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW DUANE COPPLE D.O.
Provider Business Mailing Address
First Line : 1014 SAINT CLAIR BLVD STE 1020
Second Line :
City : GONZALES
State : LA
Zip : 70737-5027
Country : US
Telephone Number : 225-743-2000
Fax Number : 225-743-2010
Provider Business Practice Location Address
First Line : 1014 SAINT CLAIR BLVD STE 1020
Second Line :
City : GONZALES
State : LA
Zip : 70737-5027
Country : US
Telephone Number : 225-743-2000
Fax Number : 225-743-2010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 12/17/2020

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Directions to “ MATTHEW DUANE COPPLE D.O.” Practice Location

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