Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS000003032 | TN |
NPI | 1043218670 |
---|---|
Provider Name | Dr. Lindsey W Cooper |
First Address | Nashville, TN 37203-1501 |
Second Address | Nashville, TN 37203-1501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 17/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3223871 | (05) | TN |
T74297 | (02) | TN |