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Individual

PAUL DANNER COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.023609
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1486621
LA
Enumeration date
07/21/2006
Last updated
11/13/2024
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