Individual
BETH ANN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
(270) 745-1200
(270) 843-5020
Mailing address
PO BOX 1100, WEST PLAINS, MO 65775-1100
(417) 257-6782
(417) 257-5878
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
02810
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115188001
—
AR
05
—
1437133733
—
MO
05
—
64068943
—
KY
Enumeration date
12/01/2005
Last updated
07/21/2022
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