Provider Demographics
NPI:1083328058
Name:COPLEY, JAMES W
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:COPLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 W CORAL REEF DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-6107
Mailing Address - Country:US
Mailing Address - Phone:480-278-9510
Mailing Address - Fax:
Practice Address - Street 1:5505 W CHANDLER BLVD STE 9
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3683
Practice Address - Country:US
Practice Address - Phone:480-207-1867
Practice Address - Fax:480-207-7899
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ224098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily