Cooper, Richard Glynn

Cooper, Richard Glynn is an individual health care provider with primary practice located at 2704 N Oak St Building E, Valdosta GA 31602-1744. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Cooper, Richard Glynn can be contacted via phone (229) 333-9729.

Contact Information

Primary practice address
2704 N Oak St Building E Valdosta GA 31602-1744
Phone: (229) 333-9729
Fax: (229) 333-0832
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 038209 Georgia

Profile Details

NPI number 1467433573
LBN Legal business name Cooper, Richard Glynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Jan 12th, 2011 - about 13 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 1467433573 NPPES
Georgia MEDICAID 000597803A

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