Individual
DR. TIMOTHY J P COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 HOSPITAL DR, SAINT PETERS, MO 63376-1659
(636) 916-9094
Mailing address
100 PERUQUE ESTATES LN, WENTZVILLE, MO 63385-4923
(636) 916-9094
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
112414
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208724807
—
MO
Enumeration date
10/03/2005
Last updated
09/05/2019
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