Provider Demographics
NPI:1215589221
Name:COPLE, RONALD ANDERSON JR (PA-C)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ANDERSON
Last Name:COPLE
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 BALD ROCK RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:VA
Mailing Address - Zip Code:24482-2821
Mailing Address - Country:US
Mailing Address - Phone:540-292-7248
Mailing Address - Fax:
Practice Address - Street 1:634 BALD ROCK RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:VA
Practice Address - Zip Code:24482-2821
Practice Address - Country:US
Practice Address - Phone:540-292-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant