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Individual

DR. TIMOTHY CHUNG COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16985 W BLUEMOUND RD, BROOKFIELD, WI 53005
(262) 641-8400
Mailing address
16985 W BLUEMOUND RD, BROOKFIELD, WI 53005-5909

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036142168
IL
207R00000X
Internal Medicine Physician
Primary
69423-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100080432
WI
Enumeration date
04/06/2014
Last updated
11/30/2021
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