Kenneth  R  Copeland  Sr  MD
Contract Details
Facility name
Provider ID
P000000341
NPI
1649481706
Tax ID
631025276
Effective Date
8/9/1994
Last Updated
4/23/2013
Direct Contract
Term Date
4/23/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1100 Jackson Highway Suite 203
Sheffield, AL 35660
United States
County
Colbert
Phone
2563898228 (Phone)
Billing Details
Address
Specialty Type
Surgery, General
Map
Address