MEDICARE: KATHARINE R. COOPER, M.D., P.C.

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	174400000X	Specialist	18123	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	160051058	OTHER	AL	MEDICARE RAILROAD ID #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	98417	OTHER	AL	ALABAMA BCBS ID #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972594265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHARINE R. COOPER, M.D., P.C.

Provider Business Mailing Address
First Line	:	3368 HIGHWAY 280
Second Line	:	SUITE 205
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3393
Country	:	US
Telephone Number	:	256-234-2464
Fax Number	:	256-234-2440

Provider Business Practice Location Address
First Line	:	3368 HIGHWAY 280
Second Line	:	SUITE 205
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-3393
Country	:	US
Telephone Number	:	256-234-2464
Fax Number	:	256-234-2440

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KATHARINE R COOPER
Credential	:	M.D.
Telephone Number	:	256-234-2464

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	11/10/2008

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Directions to “KATHARINE R. COOPER, M.D., P.C. ” Practice Location

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