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Individual

MS. DONNA M COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
545 OLD NORCROSS RD, SUITE 300, LAWRENCEVILLE, GA 30045-3389
(770) 963-6300
(678) 287-1664
Mailing address
545 OLD NORCROSS RD, SUITE 300, LAWRENCEVILLE, GA 30045-3389
(770) 963-6300
(678) 287-1664

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-01398
NC
363A00000X
Physician Assistant
Primary
002278
GA
363AS0400X
Surgical Physician Assistant
002278
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
843768621A
GA
Enumeration date
06/27/2008
Last updated
04/21/2009
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