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Individual
DR. WANTZY COOPER
Active
Individual
DR. WANTZY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
14611
CA
208600000X
Surgery Physician
MB74255
NJ
2086S0129X
Vascular Surgery Physician
Primary
005530
AZ
2086S0129X
Vascular Surgery Physician
14611
CA
208D00000X
General Practice Physician
005530
AZ
208D00000X
General Practice Physician
14611
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
585877
—
AZ
Enumeration date
10/21/2006
Last updated
04/08/2024
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