Individual
MARK A COOPER
Active
Individual
MARK A COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29115
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509513
—
TN
01
—
29115
MD LLICENSE
TN
01
—
3380640
MEDICAID GROUP
TN
01
—
38241821
MEDICARE PTAN
TN
Enumeration date
10/05/2005
Last updated
03/07/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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