Basic Information
| Provider Information | |||||||||
| NPI: | 1881041085 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COPPES | ||||||||
| FirstName: | LUCAS | ||||||||
| MiddleName: | ADRIAAN ANTON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1693 QUENTIN ST | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208483000 | ||||||||
| FaxNumber: | 7208483015 | ||||||||
| Practice Location | |||||||||
| Address1: | 1693 QUENTIN ST | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208483000 | ||||||||
| FaxNumber: | 7208483015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2016 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 125068422 | IL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | DR.0063950 | CO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.