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Individual

COOPER L NICKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
761 W 175TH ST S, CALDWELL, KS 67022-8301
(620) 845-6492
Mailing address
4612 HEARTHSIDE DR, LAWRENCE, KS 66049-3740

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-41127
KS
207Q00000X
Family Medicine Physician
Primary
04-41127
KS

Other

Enumeration date
04/17/2017
Last updated
12/07/2025
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