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General NPI Number Information
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NPI Number | 1184695306
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Entity Type | Individual
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Provider Name | CEDRIC COOPER DPM
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 647 S WASHINGTON ST
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City | RIPLEY
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State | TN
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Zip | 38063-2044
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Country | US
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Telephone | 731-635-4800
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Fax | 731-635-4801
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Provider Business Mailing Address
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Address Line | 647 S WASHINGTON ST
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City | RIPLEY
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State | TN
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Zip | 38063-2044
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Country | US
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Telephone | 731-635-4800
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Fax | 731-635-4801
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 628
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PD0142
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License Number State | LA
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