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Individual

DR. KENNETH EDWARD COOPER JR.

Active
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Individual

DR. KENNETH EDWARD COOPER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP000006912
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4355051811
MEDICARE ID NUMBER
NM
Enumeration date
08/20/2013
Last updated
01/14/2019
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