Individual
THERESA ANN COOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5995B HIGHWAY 72 E, GURLEY, AL 35748-9460
(256) 776-2094
(256) 776-0047
Mailing address
5995B HIGHWAY 72 E, GURLEY, AL 35748-9460
(256) 776-2094
(256) 776-0047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00020563
AL
208000000X
Pediatrics Physician
00020563
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
543415010
—
AL
Enumeration date
06/22/2005
Last updated
10/30/2012
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