Individual
SCOTT COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1126 S CLIFTON AVE, WICHITA, KS 67218-2913
(316) 350-8008
Mailing address
1126 S CLIFTON AVE, WICHITA, KS 67218-2913
(316) 350-8008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-43114
KS
Other
Enumeration date
06/21/2017
Last updated
08/24/2020
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