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Individual
COOPER SIMPSON
Active
Individual
COOPER SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
363A00000X
Physician Assistant
GPA-075
ID
363A00000X
Physician Assistant
Primary
PA-2111
ID
Other
Enumeration date
11/08/2016
Last updated
09/13/2023
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