Individual
DR. ROBERT WAYNE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
475 N HIGHWAY 25 W # WN, SUITE 100, WILLIAMSBURG, KY 40769-1576
(606) 549-2933
(606) 549-3036
Mailing address
PO BOX 247, JELLICO, TN 37762-0247
(606) 549-2933
(606) 549-3036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18598
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115556
HEALTHLINK
MO
01
—
135570021
MEDICARE PTAN
MO
05
—
201533510
—
MO
01
—
3518
BLUE CROSS/BLUE SHIELD
MO
05
—
7100398340
—
KY
01
—
P00792573
RAIL ROAD MEDICARE
MO
05
—
Q020836
—
TN
Enumeration date
06/13/2005
Last updated
03/12/2025
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