Healthcare Provider Details

I. General information

NPI: 1689778102
Provider Name (Legal Business Name): LINDA COOPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-5363
  • Fax: 330-480-6359
Mailing address:
  • Phone: 330-480-2363
  • Fax: 330-480-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35067727
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: