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General NPI Number Information
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NPI Number | 1740277177
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Entity Type | Individual
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Provider Name | JOSEPH DAVID COOPER MD
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 330 E 8TH ST STE 150
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City | MARIETTA
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State | OH
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Zip | 45750-3383
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Country | US
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Telephone | 740-376-5590
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Fax | 740-376-5591
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Provider Business Mailing Address
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Address Line | PO BOX 449
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City | MARIETTA
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State | OH
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Zip | 45750-0449
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Country | US
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Telephone |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 15249
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35.055064
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License Number State | OH
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