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General NPI Number Information
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NPI Number | 1225603319
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Entity Type | Individual
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Provider Name | JESSE JOEL COOPER DO
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Gender | Male
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 8929 PARALLEL PKWY
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City | KANSAS CITY
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State | KS
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Zip | 66112-3607
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Country | US
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Telephone | 913-596-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3810
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City | JOPLIN
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State | MO
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Zip | 64803-3810
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2023010776
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License Number State | MO
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