Healthcare Provider Details

I. General information

NPI: 1639133424
Provider Name (Legal Business Name): JAMES CLAUDE COOPER JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 W. SUNBRIDGE VA HOSPITAL
FAYETTEVILLE AR
72703
US

IV. Provider business mailing address

3209 E. ZION RD.
SPRINGDALE AR
72764
US

V. Phone/Fax

Practice location:
  • Phone: 479-684-2900
  • Fax: 479-571-4015
Mailing address:
  • Phone: 479-872-6558
  • Fax: 479-571-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberE1164
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: