Individual
ROBERT COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1364 CLIFTON RD, ATLANTA, GA 30322
(404) 778-4852
Mailing address
2254 E LAKE RD NE, ATLANTA, GA 30307-1838
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
R11528
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00399308B
—
GA
Enumeration date
10/25/2006
Last updated
07/08/2007
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