Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 02544 | KY |
NPI | 1013013267 |
---|---|
Provider Name | Dr. James K Cooper II |
First Address | Madisonville, KY 42431-3877 |
Second Address | Madisonville, KY 42431-3877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 18/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000044323 | BCBS PROVIDER NUMBER (01) | |
02544 | LICENSE (01) | KY |
64927379 | (05) | KY |
F48971 | (02) |