Individual
KEITH E COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3676
Mailing address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02002249A
IN
207Q00000X
Family Medicine Physician
65886-21
WI
207R00000X
Internal Medicine Physician
Primary
65886-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477505063
—
WI
Enumeration date
05/16/2006
Last updated
04/18/2024
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