Provider Demographics
NPI:1992743504
Name:COPLIN, THOMAS H (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:COPLIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 HOOPER ROAD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818
Mailing Address - Country:US
Mailing Address - Phone:225-261-7094
Mailing Address - Fax:225-261-7095
Practice Address - Street 1:13111 HOOPER ROAD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818
Practice Address - Country:US
Practice Address - Phone:225-261-7094
Practice Address - Fax:225-261-7095
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06395R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H589CP85Medicare ID - Type Unspecified