Cooper, Benjamin D

Cooper, Benjamin D is an individual health care provider with primary practice located at 223 Seneca Ln , San Carlos AZ 85550. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cooper, Benjamin D can be contacted via phone (928) 475-7244.

Contact Information

Primary practice address
223 Seneca Ln San Carlos AZ 85550
Phone: (928) 475-7244
Fax: (928) 475-7370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1795 Arizona
Eye and Vision Services Providers / Optometrist 152W00000X 2003002705 Missouri

Profile Details

NPI number 1609924273
LBN Legal business name Cooper, Benjamin D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Nov 12th, 2013 - about 11 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 1609924273 NPPES
Arizona MEDICAID 185037

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