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Individual
KEITH COOPER
Active
Individual
KEITH COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0922
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120531
UNITED HEALTHCARE
AR
05
—
134689001
—
AR
01
—
17974000000
QUALCHOICE
AR
01
—
5K846
BLUE CROSS BLUE SHIELD
AR
Enumeration date
06/29/2005
Last updated
10/13/2022
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