Individual
COOPER A MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
551 AZALEA DR, OXFORD, MS 38655-7900
(662) 234-0332
(662) 234-2891
Mailing address
551 AZALEA DR, OXFORD, MS 38655-7900
(662) 234-0332
(662) 234-2891
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13540
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115368
—
MS
01
—
64-0606089
EMPLOYER IDENTIFICATION #
MS
Enumeration date
08/23/2006
Last updated
07/15/2008
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