Individual
DR. EMILY JANE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3517 W OWEN K GARRIOTT RD STE 4, ENID, OK 73703-4953
(580) 233-5553
(580) 233-5641
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(580) 233-5553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29152
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200510880B
—
OK
01
—
P01533835
RR MEDICARE
OK
Enumeration date
03/28/2012
Last updated
08/19/2019
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