Individual
DR. JOSEPH COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-6583
(417) 269-6573
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
118195
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679560080
—
MO
05
—
204700108
—
MO
Enumeration date
09/30/2005
Last updated
08/19/2019
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