Organization
COOPER SURGICAL ASSCOCIATES
Active
Parent organization
COOPER SURGICAL ASSCOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOPER SURGICAL ASSCOCIATES
Authorized official
ROBERT MCMULLEN (EVP - MANAGED CARE)
(856) 968-7263
Entity
Organization
Contact information
Practice address
3 COOPER PLZ, SUITE 411, CAMDEN, NJ 08103-1438
(856) 342-3250
Mailing address
3 COOPER PLZ, SUTIE 502, CAMDEN, NJ 08103-1438
(856) 968-7433
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2843948000
AMERIHEALTH/KEYSTONE/IBC
NJ
05
—
2865807
—
NJ
Enumeration date
08/23/2007
Last updated
08/23/2007
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