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Individual

KENT J COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2401 S TUCKER AVE, STE. 2, PITTSBURG, KS 66762-6609
(620) 231-6280
(620) 231-6342
Mailing address
2401 S TUCKER AVE, STE. 2, PITTSBURG, KS 66762-6609
(620) 231-6280

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15873
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100086050A
KS
Enumeration date
10/02/2006
Last updated
07/08/2007
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