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NPI Code Detail

MEDICARE: DR. SPENCER THOMAS COPLAND MD

MEDICARE: DR. SPENCER THOMAS COPLAND MD
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
1207QS0010XSports Medicine (Family Medicine) Physician2007-01233NC

General Provider Information

NPI Number : 1376672832
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SPENCER THOMAS COPLAND MD
Provider Business Mailing Address
First Line : 1200 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1004
Country : US
Telephone Number : 336-832-7000
Fax Number :
Provider Business Practice Location Address
First Line : 940 GOLF HOUSE CT E
Second Line : LEBAUER HEALTHCARE AT STONEY CREEK
City : WHITSETT
State : NC
Zip : 27377-9296
Country : US
Telephone Number : 336-449-9848
Fax Number : 336-449-9749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 09/24/2021

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