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Organization
COOPER SURGICAL ASSOCIATES, PA
Active
Organization
COOPER SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MCMULLEN (EVP MANAGED CARE ADMIN)
(856) 342-7369
Entity
Organization
Contact information
Practice address
6225 MAIN ST, VOORHEES, NJ 08043-4629
(856) 325-6674
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 968-7433
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
NULL
207XX0801X
Orthopaedic Trauma Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2238408000
AMERIHEALTH GRP NUMBER
NJ
05
—
7161701
—
NJ
Enumeration date
03/27/2007
Last updated
06/26/2008
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