Provider Demographics
NPI:1780874990
Name:COPLEY MEDICAL GROUP, INC
Entity type:Organization
Organization Name:COPLEY MEDICAL GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:PANZNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-666-4158
Mailing Address - Street 1:3632 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3198
Mailing Address - Country:US
Mailing Address - Phone:330-666-4158
Mailing Address - Fax:330-668-2256
Practice Address - Street 1:3632 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-3198
Practice Address - Country:US
Practice Address - Phone:330-666-4158
Practice Address - Fax:330-668-2256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty