Individual
DR. CARROLL DONELL COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 MEDICAL WAY, SUITE B, RIVERDALE, GA 30274-2522
(678) 974-0158
Mailing address
3161 HOWELL MILL RD NW, SUITE 310, ATLANTA, GA 30327-2135
(678) 974-0158
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
63309
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
63309
GA
Other
Enumeration date
11/02/2006
Last updated
04/27/2017
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