Provider Demographics
NPI:1891008199
Name:COPLEN, ZACHERY AARON
Entity Type:Individual
Prefix:
First Name:ZACHERY
Middle Name:AARON
Last Name:COPLEN
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 1:609 NW 89TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-3019
Mailing Address - Country:US
Mailing Address - Phone:405-623-3105
Mailing Address - Fax:
Practice Address - Street 1:647 N KICKAPOO AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6063
Practice Address - Country:US
Practice Address - Phone:405-214-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator