Individual
JOHN GREGORY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 KY HIGHWAY 36 E, SUITE 2 C, CYNTHIANA, KY 41031-7490
(859) 234-6000
(859) 234-6011
Mailing address
1210 KY HIGHWAY 36 E, SUITE 2 C, CYNTHIANA, KY 41031-7490
(859) 234-6000
(859) 234-6011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21195
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000041815
ANTHEM
KY
01
—
1049879
AETNA
KY
05
—
64211956
—
KY
Enumeration date
06/05/2006
Last updated
09/26/2012
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