MEDICARE: DR. MILISSA ANN COOPER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	3014	AZ

General Provider Information

NPI Number	:	1598752164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILISSA ANN COOPER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 25745
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-0112
Country	:	US
Telephone Number	:	623-582-2355
Fax Number	:

Provider Business Practice Location Address
First Line	:	20033 N 19TH AVE STE 111
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-4247
Country	:	US
Telephone Number	:	623-582-2355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	02/09/2026

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Directions to “ DR. MILISSA ANN COOPER D.O.” Practice Location

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