Cooper, Mark Abe

Cooper, Mark Abe is an individual health care provider with primary practice located at 1895 Kingsley Ave. Suite 303, Orange Park FL 32073. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Cooper, Mark Abe can be contacted via phone (904) 272-6161.

Contact Information

Primary practice address
1895 Kingsley Ave. Suite 303 Orange Park FL 32073
Phone: (904) 272-6161
Fax: (904) 272-9797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1799 Florida

Profile Details

NPI number 1861453334
LBN Legal business name Cooper, Mark Abe
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Mar 4th, 2009 - about 15 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 1861453334 NPPES
Georgia MEDICAID 461070816A
Georgia MEDICAID 2907216-00

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