Cooper, Leslie W

Cooper, Leslie W is an sole proprietor health care provider with primary practice located at 420 E South Temple Ste 515 , Salt Lake City UT 84111-1380. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Cooper, Leslie W can be contacted via phone (801) 415-1828.

Contact Information

Primary practice address
420 E South Temple Ste 515 Salt Lake City UT 84111-1380
Phone: (801) 415-1828
Fax: (801) 384-0463
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5614879-1205 Utah
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 5614879-1205 Utah

Profile Details

NPI number 1023122611
LBN Legal business name Cooper, Leslie W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2006
Last updated Dec 12th, 2018 - 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 1023122611 NPPES
Utah Other 735332 DMBA
Utah MEDICAID D5485 DMBA
Utah Other 735332 DMBA

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