Provider Demographics
NPI:1013921956
Name:COPELAND, KATHRYN A (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:COPELAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:HOLLINGSWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:679 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1049
Mailing Address - Country:US
Mailing Address - Phone:317-807-1266
Mailing Address - Fax:317-859-4269
Practice Address - Street 1:12188A N MERIDIAN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4578
Practice Address - Country:US
Practice Address - Phone:317-890-2000
Practice Address - Fax:317-564-5556
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057877A2088F0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000350999OtherANTHEM PROVIDER NUMBER
IN200450500Medicaid
1487680518OtherGROUP NPI #
INH15711Medicare UPIN
INP00200146OtherMEDICARE RAILROAD
IN200288740OtherMEDICAID GROUP NUMBER
IN200450500Medicaid
IN677730RRMedicare PIN