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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962446104 | NPPES |
| Idaho | MEDICAID | 003624900 |
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