MEDICARE: JAMESVILLE FAMILY MEDICINE AND WELLNESS PC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1245481225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMESVILLE FAMILY MEDICINE AND WELLNESS PC

Provider Business Mailing Address
First Line	:	4615 NORTH ST
Second Line	:
City	:	JAMESVILLE
State	:	NY
Zip	:	13078-9499
Country	:	US
Telephone Number	:	315-469-7600
Fax Number	:	315-469-7775

Provider Business Practice Location Address
First Line	:	4615 NORTH ST
Second Line	:
City	:	JAMESVILLE
State	:	NY
Zip	:	13078-9499
Country	:	US
Telephone Number	:	315-469-7600
Fax Number	:	315-469-7775

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. DEVIN COPPOLA
Credential	:	MD
Telephone Number	:	315-469-7600

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	03/16/2009

Similar Medicare Providers

1306885108 — DEVIN COPPOLA MD
Practice Location Address:

4615 NORTH ST
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13078-9499

Practice Phone: 315-469-7600
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1235625344 — MOLLY FISCHER
Practice Location Address:

4613 NORTH ST
JAMESVILLE, NY
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1548254055 — DR. KURT A D'AMICO DDS
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1417931619 — THE NOTTINGHAM RESIDENTIAL HEALTH CARE FACILITY
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