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Individual

DR. JOSEPH DONALD COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4352 VALLEY FORGE DR, FAIRVIEW PARK, OH 44126-2825
(440) 331-8215
Mailing address
4352 VALLEY FORGE DR, FAIRVIEW PARK, OH 44126-2825

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34006607C
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2208846
OH
01
942460636300
CARESOURCE
OH
01
P00220791
MEDICARE TRAVELERS RR-GA
OH
Enumeration date
06/09/2006
Last updated
01/11/2011
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