Individual
DR. REGINALD R COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16595
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0025523
—
IA
01
—
02552
WELLMARK BCBS
IA
Enumeration date
09/19/2005
Last updated
11/28/2007
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