Cooper, Clive R

Cooper, Clive R is an individual health care provider with primary practice located at 600 N Robbins Rd , Boise ID 83702-4565. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Cooper, Clive R can be contacted via phone (208) 385-3329.

Contact Information

Primary practice address
600 N Robbins Rd Boise ID 83702-4565
Phone: (208) 385-3329
Fax: (208) 489-4063
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X M6445 Idaho
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X M6445 Idaho

Profile Details

NPI number 1962446104
LBN Legal business name Cooper, Clive R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Aug 10th, 2017 - about 7 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 1962446104 NPPES
Idaho MEDICAID 003624900

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