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General NPI Number Information
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NPI Number | 1952332538
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Entity Type | Organization
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Legal Business Name | CAROL H COOPER MD PSC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 1200 CENTRAL AVE SUITE 4
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City | ASHLAND
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State | KY
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Zip | 41101
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Country | US
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Telephone | 606-324-1483
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Fax | 606-329-2612
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Provider Business Mailing Address
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Address Line | 1200 CENTRAL AVE SUITE 4
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City | ASHLAND
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State | KY
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Zip | 41101
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Country | US
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Telephone | 606-324-1483
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Fax | 606-329-2612
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CAROL H COOPER
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Credential | MD
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Telephone | 606-324-1483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 28550
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License Number State | KY
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