Individual
RONALD J COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 DELAFIELD ST, SUITE 219, WAUKESHA, WI 53188-3417
(262) 951-8508
Mailing address
7060 RAINBOW LAKE RD, LAKE TOMAHAWK, WI 54539-9303
(715) 892-6915
(715) 277-4577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30575600
—
WI
Enumeration date
05/20/2006
Last updated
12/02/2020
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