Cooley, Charles R

Cooley, Charles R is an individual health care provider with primary practice located at 720 Transit Ave Suite 101, Canton GA 30114-2571. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Cooley, Charles R can be contacted via phone (770) 720-7000.

Contact Information

Primary practice address
720 Transit Ave Suite 101 Canton GA 30114-2571
Phone: (770) 720-7000
Fax: (770) 720-7055
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 035839 Georgia

Profile Details

NPI number 1548219330
LBN Legal business name Cooley, Charles R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548219330 NPPES
Georgia MEDICAID 00512036C

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