Provider Demographics
NPI:1083743546
Name:COPLAND, JESSICA CAMPBELL (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:CAMPBELL
Last Name:COPLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5516 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2708
Mailing Address - Country:US
Mailing Address - Phone:704-446-7700
Mailing Address - Fax:704-446-7795
Practice Address - Street 1:5516 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2708
Practice Address - Country:US
Practice Address - Phone:704-446-7700
Practice Address - Fax:704-446-7795
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine