Healthcare Provider Details

I. General information

NPI: 1215490784
Provider Name (Legal Business Name): DAVID WAYNE COOPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 FORT SANDERS WEST BLVD
KNOXVILLE TN
37922-3355
US

IV. Provider business mailing address

256 FORT SANDERS WEST BLVD STE 200
KNOXVILLE TN
37922-3355
US

V. Phone/Fax

Practice location:
  • Phone: 865-558-4400
  • Fax: 865-558-4421
Mailing address:
  • Phone: 865-934-3329
  • Fax: 865-769-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01092439A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number01092439A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: