Cooper, Jerry Dewayne

Cooper, Jerry Dewayne is an individual health care provider with primary practice located at 275 Collier Rd Nw Suite 290, Atlanta GA 30309-1709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Cooper, Jerry Dewayne can be contacted via phone (404) 352-3300.

Contact Information

Primary practice address
275 Collier Rd Nw Suite 290 Atlanta GA 30309-1709
Phone: (404) 352-3300
Fax: (404) 352-9453
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 013262 Georgia

Profile Details

NPI number 1396728598
LBN Legal business name Cooper, Jerry Dewayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Mar 26th, 2013 - about 12 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 1396728598 NPPES
Georgia MEDICAID 00134142G

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