Individual
DR. BRUCE DAVID COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 BRISTLECONE DR, FORT COLLINS, CO 80524-2031
(970) 224-5209
(970) 221-7165
Mailing address
120 BRISTLECONE DR, FORT COLLINS, CO 80524-2031
(970) 224-5209
(970) 221-7165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
24912
CO
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
24912
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01249127
—
CO
Enumeration date
11/29/2005
Last updated
11/21/2007
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