Spencer Garrett Copeland

Individual provider Active NPI Electroneurodiagnostic Specialist/Technologist · Gilbert, AZ

NPI 1861064008 · NPPES record last updated Jul 16, 2021

Key facts

NPI
1861064008
Entity type
Individual (NPI type 1)
Primary specialty
Electroneurodiagnostic Specialist/Technologist 246ZE0600X
Practice address
2301 W. Sanoque CT
Gilbert, AZ 85298
Phone
(602) 734-1405
NPI assigned
Jul 16, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Iom LLC Electroneurodiagnostic Past
since Jul 25, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X Yes

Addresses

Primary practice location

2301 W. Sanoque CT
Gilbert, AZ 85298

Mailing address

825 W Osborn Rd Apt 4027
Phoenix, AZ 85013-3674
Phone (210) 861-6011

Other providers in Gilbert, AZ

All providers in Gilbert, AZ · Electroneurodiagnostic Specialist/Technologist in Arizona

Sources for this page

Verify at the official NPI Registry.