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NPI Code Detail

MEDICARE: MORGAN ENGMANN-COOPER MD

MEDICARE: MORGAN ENGMANN-COOPER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073214920
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN ENGMANN-COOPER MD
Provider Business Mailing Address
First Line : 801 N RUTLEDGE ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62702-4933
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 801 N RUTLEDGE ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62702-4933
Country : US
Telephone Number : 217-545-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2023
Last Update Date : 07/03/2024

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