Individual
JAMIE L COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1205 HADLEY RD, MOORESVILLE, IN 46158-1737
(317) 584-3454
(317) 584-3435
Mailing address
8051 S EMERSON AVE STE 400, INDIANAPOLIS, IN 46237-8633
(317) 865-3600
(317) 885-3850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02002828A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000480530
ANTHEM
IN
01
—
000000720579
ANTHEM
IN
01
—
1935002
CIGNA
IN
05
—
200543500
—
IN
01
—
7554169
AETNA
IN
Enumeration date
06/06/2006
Last updated
07/01/2019
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