# COOPER MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COOPER MEDICAL GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881996130
- **Authorized official:** DR. KEITH EUGENE COOPER D.O. (OWNER / PHYSICIAN)
- **Authorized official phone:** (812) 476-4161

## Contact information

- **Practice address:** 1401 S GREEN RIVER RD, EVANSVILLE, IN 47715-5657
- **Practice address phone:** (812) 476-4161
- **Practice address fax:** (812) 476-4178
- **Mailing address:** 1401 S GREEN RIVER RD, EVANSVILLE, IN 47715-5657
- **Mailing address phone:** (812) 476-4161
- **Mailing address fax:** (812) 476-4178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02002249A | IN | Yes |

## Other

- **Enumeration date:** 11/18/2010
- **Last updated:** 12/14/2010