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NPI Code Detail

MEDICARE: JOSEPH COOPER DO

MEDICARE: JOSEPH COOPER 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
1208D00000XGeneral Practice Physician5101028773MI

General Provider Information

NPI Number : 1982345955
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH COOPER DO
Provider Business Mailing Address
First Line : 212 BOB WHITE LN
Second Line :
City : QUICKSBURG
State : VA
Zip : 22847-1437
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6245 INKSTER RD
Second Line :
City : GARDEN CITY
State : MI
Zip : 48135-4001
Country : US
Telephone Number : 734-458-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2022
Last Update Date : 12/10/2025

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