Organization
CAROL H COOPER MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL H COOPER MD (PHYSICIAN)
(606) 324-1483
Entity
Organization
Contact information
Practice address
1200 CENTRAL AVE, SUITE 4, ASHLAND, KY 41101
(606) 324-1483
(606) 329-2612
Mailing address
1200 CENTRAL AVE, SUITE 4, ASHLAND, KY 41101
(606) 324-1483
(606) 329-2612
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
28550
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050199
BLUE CROSS
KY
05
—
64285505
—
KY
01
—
7239
MEDICARE ID
KY
Enumeration date
07/05/2006
Last updated
01/18/2008
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