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Individual

GEORGE LEONARD COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2139 VALLEYGATE DR, STE 101A, FAYETTEVILLE, NC 28304-3666
(910) 323-2002
(910) 323-3477
Mailing address
2139 VALLEYGATE DR, STE 101A, FAYETTEVILLE, NC 28304-3666
(910) 323-2002
(910) 323-3477

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
1925301
NY
207W00000X
Ophthalmology Physician
31520
KY
207W00000X
Ophthalmology Physician
Primary
9600893
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0838866
UHC PROVIDER NUMBER
NC
01
1083N
BC/BS PROVIDER NUMBER
NC
05
891083N
NC
Enumeration date
06/09/2005
Last updated
11/24/2015
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