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General NPI Number Information
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NPI Number | 1184847873
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Entity Type | Organization
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Legal Business Name | COOPER PHYSICIAN OFFICES
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 PLAZA DR SUITE 103
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City | SEWELL
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State | NJ
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Zip | 08080-9207
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Country | US
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Telephone | 856-270-4080
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Fax | 856-270-4085
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Provider Business Mailing Address
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Address Line | 3 COOPER PLZ SUITE 502
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone | 856-342-2921
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Fax | 856-968-8499
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Authorized Official
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Title or Position | EVP MANAGED CARE
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Name | ROBERT MCMULLEN
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Credential |
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Telephone | 856-342-2921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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