# DR. WANTZY COOPER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1942383393
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 14611 | CA | — |
| 208600000X | Surgery Physician | MB74255 | NJ | — |
| 2086S0129X | Vascular Surgery Physician | 005530 | AZ | Yes |
| 2086S0129X | Vascular Surgery Physician | 14611 | CA | — |
| 208D00000X | General Practice Physician | 005530 | AZ | — |
| 208D00000X | General Practice Physician | 14611 | CA | — |

## Other

- **Enumeration date:** 10/21/2006
- **Last updated:** 04/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 585877 | — | AZ |