Provider Demographics
NPI:1538121694
Name:COPELAND, ROBERT A (OD,FCOVD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:COPELAND
Suffix:
Gender:M
Credentials:OD,FCOVD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BERSHIRE COURT
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-374-3134
Mailing Address - Fax:610-374-0484
Practice Address - Street 1:50 BERKSHIRE COURT
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-374-3134
Practice Address - Fax:610-374-0484
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000310152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01530601OtherBLUE CROSS PROVIDER ID
PA01530601OtherKEYSTONE/SEN BLUE PROVIDE
PA54384000OtherDAVIS AFFINITY
PA0057448OtherAETNA/HMO
PA212211591OtherBERKSHIRE HEALTH PLAN
PA2145127OtherUNITED HEALTHCARE
PA232211591OtherHUMANA
PA8872475OtherCIGNA
PA0020565000OtherLEYSTONE EAST PROVIDER ID
PA0020565000OtherAMERIHEALTH PROVIDER ID
PA93596OtherHIGHMARK BS PROVIDER ID
PA0020565000OtherINDEPENDENCE BC/BS
PA2206957OtherSECURE HORIZON
PA29435/29436OtherSPECTERA
PA385701OtherHEALTHAMERICA/HEALTH ASSURANCE
PA2820OtherGEISINGER HEALTH PLAN
PA410023366OtherMEDICARE RAILROAD
PA4356887OtherAETNA TRADITIONAL/PPO
PA93596OtherHIGHMARK BS PROVIDER ID
PAT28465Medicare UPIN
PA0966540001Medicare NSC