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DR. MARTHA LOUISE COOPER M.D.
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1538376942
Individual Registrant:DR. MARTHA LOUISE COOPER M.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
807 S ISABELLA ST SYLVESTER, GA 31791-7554 US
Tel: 229-776-9143 Fax: --
Tel: 229-776-9143 Fax: --
Contact information for business:
807 S ISABELLA ST SYLVESTER, GA 31791-7554 US
Tel: 229-776-9143 Fax: --
Tel: 229-776-9143 Fax: --
Registration Information:
NPI: 1538376942
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | GA | BC4653247 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RAILROAD MEDICARE | P00242174 | GA | 01 |
| 000689279E | GA | 05 | |
| BCBS OF GEORGIA | 52623456004 | GA | 01 |
