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COOPER CLINIC PA NPI 1922014521


NPI Information

NPI: 1922014521
Provider Name: COOPER CLINIC, PA
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1801 E MAIN ST
CHARLESTON, AR
ZIP 72933
Phone: (479) 274-2000
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COOPER CLINIC, PA is a clinic center in Charleston, AR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). COOPER CLINIC, PA NPI is 1922014521. The provider is registered as an organization entity type.

The provider's business location address is:

1801 E MAIN ST
CHARLESTON, AR
ZIP 72933-254
Phone: (479) 274-2000

The provider's authorized official is Curtis Ralston .
The authorized official title is Ceo and has the following contact phone number (479) 274-2000.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 9/1/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterMC-0254ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10384730016MEDICARE NSCARKANSAS
2138674002MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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