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General NPI Number Information
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NPI Number | 1366973786
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Entity Type | Individual
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Provider Name | JOHN PAUL COOPER MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 1800 BY PASS RD
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-9135
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Country | US
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Telephone | 501-206-3102
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 N ILLINOIS AVE
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City | CARBONDALE
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State | IL
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Zip | 62901-5612
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Country | US
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Telephone | 618-833-1691
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 87237
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036.162871
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 71890-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | E-11652
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License Number State | AR
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