Provider Demographics
NPI:1316058787
Name:COPELAND, DEBORAH LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LEIGH
Last Name:COPELAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MILLSAPS DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1347
Mailing Address - Country:US
Mailing Address - Phone:601-261-5710
Mailing Address - Fax:
Practice Address - Street 1:110 MILLSAPS DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1347
Practice Address - Country:US
Practice Address - Phone:601-261-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00024203207Q00000X
MS13947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0100753OtherMEDICARE COMPLETE
AL009941424Medicaid
AL051005023OtherBLUE CROSS
AL48619OtherSENIORS FIRST
ALG37101OtherVIVA HEALTH
AL009941424Medicaid
G37101Medicare UPIN