Individual
JERRY DEWAYNE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 COLLIER RD NW, SUITE 290, ATLANTA, GA 30309-1709
(404) 352-3300
(404) 352-9453
Mailing address
275 COLLIER RD NW, SUITE 290, ATLANTA, GA 30309-1709
(404) 352-3300
(404) 352-9453
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
013262
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00134142G
—
GA
Enumeration date
11/22/2005
Last updated
03/26/2013
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