Individual
KEITH E COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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