Healthcare Provider Details

I. General information

NPI: 1851787444
Provider Name (Legal Business Name): MATTHEW W COOPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N CAUSEWAY BLVD
MANDEVILLE LA
70471-3104
US

IV. Provider business mailing address

1420 N CAUSEWAY BLVD
MANDEVILLE LA
70471-3104
US

V. Phone/Fax

Practice location:
  • Phone: 985-327-5905
  • Fax: 985-200-0840
Mailing address:
  • Phone: 985-327-5905
  • Fax: 985-200-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number325406
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number325406
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: