Individual
KEITH COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
437 DENISON ST, CONWAY, AR 72034-6127
(501) 327-1325
(501) 327-1328
Mailing address
PO BOX 9662, CONWAY, AR 72033-9662
(501) 852-1363
(501) 852-1364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0922
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120531
UNITED HEALTHCARE
AR
05
—
134689001
—
AR
01
—
17974000000
QUALCHOICE
AR
01
—
5K846
BLUE CROSS BLUE SHIELD
AR
Enumeration date
06/29/2005
Last updated
10/13/2022
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