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NPI 1699918383

NPI 1699918383 : THOMAS MICHAEL COOPER MD : KANSAS CITY, MO

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General NPI Number Information
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    NPI Number           |    1699918383
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS MICHAEL COOPER MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/11/2009
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    Last Update Date     |    04/03/2019
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Provider Practice Location Address
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    Address Line         |    4401 WORNALL RD 
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    City                 |    KANSAS CITY
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    State                |    MO
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    Zip                  |    64111
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    Country              |    US
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    Telephone            |    816-932-3679
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    Fax                  |    816-932-9089
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Provider Business Mailing Address
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    Address Line         |    901 E 104TH ST 
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    City                 |    KANSAS CITY
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    State                |    MO
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    Zip                  |    64131-4517
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    Country              |    US
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    Telephone            |    816-502-7117
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    Fax                  |    816-932-9670
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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        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    2010034069
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    License Number State |    MO
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Taxonomy #2
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    Taxonomy Code        |    207RC0200X
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    Taxonomy Name        |    Critical Care Medicine (Internal Medicine) Physician
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    License Number       |    2010034069
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    License Number State |    MO
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Taxonomy #3
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    Taxonomy Code        |    207LC0200X
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    Taxonomy Name        |    Critical Care Medicine (Anesthesiology) Physician
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    License Number       |    2010034069
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    License Number State |    MO
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