Cooper, Mark W

Cooper, Mark W is an individual health care provider with primary practice located at 1103 Village Square Dr Suite 100, Perrysburg OH 43551-1783. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Cooper, Mark W can be contacted via phone (419) 874-8745.

Contact Information

Primary practice address
1103 Village Square Dr Suite 100 Perrysburg OH 43551-1783
Fax: (419) 874-8748
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3895 Ohio

Profile Details

NPI number 1801896014
LBN Legal business name Cooper, Mark W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jul 8th, 2007 - about 17 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 1801896014 NPPES
Ohio MEDICAID 0608631

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