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General NPI Number Information
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NPI Number | 1437134764
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Entity Type | Individual
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Provider Name | MICHAEL A COOPER PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | CHANDLER MEDICAL CTR DIVISION OF GASTROENTEROLOGY 800 ROSE STREET, ROOM MN 649
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-5021
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Fax | 859-257-8860
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Provider Business Mailing Address
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Address Line | 922 CHARWOOD DR
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City | LEXINGTON
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State | KY
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Zip | 40515-5009
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Country | US
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Telephone | 859-273-5579
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Fax | 859-257-8860
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA145
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA145
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA145
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License Number State | KY
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