Cooper, Timothy R
Cooper, Timothy R is an individual health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Cooper, Timothy R can be contacted via phone (877) 229-0273.Contact Information
Primary practice address
2845 Greenbrier Rd
Green Bay WI 54311-6519
Phone: (877) 229-0273
Fax: (920) 288-4863
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 33935 | Wisconsin |
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 33935-020 | Wisconsin |
Profile Details
NPI number | 1033192943 |
---|---|
LBN Legal business name | Cooper, Timothy R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 23rd, 2005 |
Last updated | Apr 9th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1033192943 | NPPES |
Michigan | MEDICAID | 104896578 | |
Michigan | Other | P00355798 | |
Michigan | MEDICAID | 32037400 |
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