Cooper, Jac Alan
Cooper, Jac Alan is an individual health care provider with primary practice located at 85 E Us Highway 6 Ste 240 , Valparaiso IN 46383. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Critical Care, which is considered as his primary health care specialty. Cooper, Jac Alan can be contacted via phone (219) 983-6240.Contact Information
Primary practice address
85 E Us Highway 6 Ste 240
Valparaiso IN 46383
Phone: (219) 983-6240
Fax: (219) 983-6040
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 01035869A | Indiana |
Profile Details
NPI number | 1760487425 |
---|---|
LBN Legal business name | Cooper, Jac Alan |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 17th, 2005 |
Last updated | Sep 14th, 2020 - about 5 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 | 1760487425 | NPPES |
Indiana | MEDICAID | 100207020 | |
Indiana | Other | 000000082449 |
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