Provider Demographics
NPI:1548360217
Name:COPE FAMILY MEDICINE LC
Entity type:Organization
Organization Name:COPE FAMILY MEDICINE LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-298-4112
Mailing Address - Street 1:620 MEDICAL DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5084
Mailing Address - Country:US
Mailing Address - Phone:801-298-4112
Mailing Address - Fax:801-298-5397
Practice Address - Street 1:620 MEDICAL DR
Practice Address - Street 2:SUITE 150
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5084
Practice Address - Country:US
Practice Address - Phone:801-298-4112
Practice Address - Fax:801-298-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty