Cooper, Justin R

Cooper, Justin R is an individual health care provider with primary practice located at 2400 17Th St , Columbus IN 47201-5351. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is his primary health care specialty. Cooper, Justin R can be contacted via phone (812) 376-5757.

Contact Information

Primary practice address
2400 17Th St Columbus IN 47201-5351
Phone: (812) 376-5757
Fax: (812) 376-5058
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X 71003003A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71003003A Indiana

Profile Details

NPI number 1710121959
LBN Legal business name Cooper, Justin R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2009
Last updated Jan 8th, 2024 - about last year

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 1710121959 NPPES
Indiana MEDICAID 201112920

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