Healthcare Provider Details

I. General information

NPI: 1467375790
Provider Name (Legal Business Name): COOPER ALLISON SAUSSY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 ALTAMA CONNECTOR
BRUNSWICK GA
31525-1888
US

IV. Provider business mailing address

133 ALTAMA CONNECTOR
BRUNSWICK GA
31525-1888
US

V. Phone/Fax

Practice location:
  • Phone: 912-265-3833
  • Fax:
Mailing address:
  • Phone: 912-265-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADS001199
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: