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NPI Code Detail

MEDICARE: DR. ANTHONY L. COOPER JR. DO

MEDICARE: DR. ANTHONY L. COOPER JR. DO
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
1208100000XPhysical Medicine & Rehabilitation Physician88057GA

General Provider Information

NPI Number : 1912434986
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY L. COOPER JR. DO
Provider Business Mailing Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 252-847-4268
Fax Number :
Provider Business Practice Location Address
First Line : 2200 PATRICK HENRY PKWY
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-4207
Country : US
Telephone Number : 678-620-8035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2017
Last Update Date : 07/21/2022

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