=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598954109
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM H COOPER, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2007
-----------------------------------------------------
Last Update Date | 10/19/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8671 S QUEBEC ST SUITE 250
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80130-5859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-791-6447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8671 S QUEBEC ST SUITE 250
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80130-5859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-791-6447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | WILLIAM H COOPER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 303-791-6447
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0505X
-----------------------------------------------------
Taxonomy Name | Adult Medicine Physician
-----------------------------------------------------
License Number | 34773
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------