Organization
EDWIN B COOPER, JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN B COOPER JR. MD (PRESIDENT)
(252) 522-5881
Entity
Organization
Contact information
Practice address
1001 N QUEEN ST, KINSTON, NC 28501-3945
(252) 522-5881
Mailing address
100 AIRPORT RD, KINSTON, NC 28501-1604
(252) 522-5881
(252) 527-2923
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3513
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2335663
MEDICARE GROUP
NC
Enumeration date
09/14/2007
Last updated
09/14/2007
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