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General NPI Number Information
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NPI Number | 1285820068
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Entity Type | Organization
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Legal Business Name | EDWIN B COOPER, JR MD PA
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 1001 N QUEEN ST
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City | KINSTON
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State | NC
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Zip | 28501-3945
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Country | US
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Telephone | 252-522-5881
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Fax |
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Provider Business Mailing Address
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Address Line | 100 AIRPORT RD
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City | KINSTON
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State | NC
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Zip | 28501-1604
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Country | US
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Telephone | 252-522-5881
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Fax | 252-527-2923
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWIN B COOPER JR.
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Credential | MD
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Telephone | 252-522-5881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 3513
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License Number State | NC
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