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General NPI Number Information
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NPI Number | 1255345294
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Entity Type | Individual
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Provider Name | DONALD L. COOPER DO
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 700 W 7TH AVE SUITE 103
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City | BRISTOW
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State | OK
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Zip | 74010-2302
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Country | US
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Telephone | 918-367-5531
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Fax | 918-367-1747
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Provider Business Mailing Address
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Address Line | 700 W 7TH AVE SUITE 103
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City | BRISTOW
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State | OK
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Zip | 74010-2302
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Country | US
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Telephone | 918-367-5531
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Fax | 918-367-1747
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1938
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License Number State | OK
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