Individual
TINA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19875
OK
Other
Enumeration date
12/22/2005
Last updated
09/14/2016
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