Cooper, Clayton E
Cooper, Clayton E is an sole proprietor health care provider with primary practice located at 801 E Main St , Tishomingo OK 73460-2351. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Cooper, Clayton E can be contacted via phone (580) 371-3776.Contact Information
Primary practice address
801 E Main St
Tishomingo OK 73460-2351
Phone: (580) 371-3776
Fax: (580) 371-2056
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1942545991 |
|---|---|
| LBN Legal business name | Cooper, Clayton E |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 3rd, 2012 |
| Last updated | Dec 3rd, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942545991 | NPPES |
| Oklahoma | MEDICAID | 200226970A |
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