Healthcare Provider Details

I. General information

NPI: 1407181118
Provider Name (Legal Business Name): LINDA LESLIE COOPER M.D., C.M., FRCSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 SHAGANAPPI TRAIL NW VISION CLINIC ALBERTA CHILDREN'S HOSPITAL
CALGARY ALBERTA
T3H 3R6
CA

IV. Provider business mailing address

2888 SHAGANAPPI TRAIL NW VISION CLINIC, ALBERTA CHILDREN'S HOSPITAL
CALGARY ALBERTA
T3H 3R6
CA

V. Phone/Fax

Practice location:
  • Phone: 403-955-7940
  • Fax: 403-955-7672
Mailing address:
  • Phone: 403-955-7940
  • Fax: 403-955-7672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number151418
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: