Individual
DR. IVAN N COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M., P.C.
Contact information
Practice address
1932 ALCOA HWY, SUITE C-480, KNOXVILLE, TN 37920-1527
(865) 632-5700
(865) 632-5778
Mailing address
1932 ALCOA HWY, SUITE C-480, KNOXVILLE, TN 37920-1527
(865) 632-5700
(865) 632-5778
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM132
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008103
BLUE CROSS
TN
05
—
3350481
—
TN
Enumeration date
10/13/2006
Last updated
12/31/2010
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