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General NPI Number Information
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NPI Number | 1114923182
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Entity Type | Individual
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Provider Name | RICHARD E. COOPER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 3940 ARROWHEAD BLVD SUITE 230
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City | MEBANE
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State | NC
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Zip | 27302-7636
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Country | US
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Telephone | 919-304-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 3940 ARROWHEAD BLVD SUITE 230
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City | MEBANE
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State | NC
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Zip | 27302-7636
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Country | US
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Telephone | 919-304-1081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 21435
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2010-01962
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License Number State | NC
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