Individual
RANDY I COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7362 W THUNDERBIRD RD STE 103, PEORIA, AZ 85381-5028
(480) 610-6152
(480) 610-6189
Mailing address
2149 E WARNER RD, SUITE 101, TEMPE, AZ 85284-3494
(480) 610-6100
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
30432
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
722464
—
AZ
Enumeration date
09/13/2005
Last updated
10/04/2021
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