Provider Demographics
NPI:1518130491
Name:ZEBRA MEDICINE, PLLC
Entity Type:Organization
Organization Name:ZEBRA MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:COPUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-284-5591
Mailing Address - Street 1:2055 E SOUTHERN AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7507
Mailing Address - Country:US
Mailing Address - Phone:480-284-5591
Mailing Address - Fax:480-284-6989
Practice Address - Street 1:2055 E SOUTHERN AVE
Practice Address - Street 2:SUITE H
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7507
Practice Address - Country:US
Practice Address - Phone:480-284-5591
Practice Address - Fax:480-284-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty