Healthcare Provider Details

I. General information

NPI: 1043624232
Provider Name (Legal Business Name): JENNIFER AFTON COOPER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SAINT VINCENT CIR STE 300
LITTLE ROCK AR
72205-5417
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

V. Phone/Fax

Practice location:
  • Phone: 501-552-8800
  • Fax: 501-552-5343
Mailing address:
  • Phone: 214-645-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberE-14916
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberV4899
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: