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General NPI Number Information
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NPI Number | 1750810560
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Entity Type | Individual
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Provider Name | BENJAMIN JOHN COOPER MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 260 26TH ST
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City | PRAIRIE DU SAC
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State | WI
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Zip | 53578-2203
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Country | US
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Telephone | 608-643-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8603
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 81300-20
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License Number State | WI
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