Cooper, Jack Marshall

Cooper, Jack Marshall is an individual health care provider with primary practice located at 470 Taylor Rd Suite 202, Montgomery AL 36117-3563. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Cooper, Jack Marshall can be contacted via phone (334) 244-6773.

Contact Information

Primary practice address
470 Taylor Rd Suite 202 Montgomery AL 36117-3563
Phone: (334) 244-6773
Fax: (334) 244-4234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2012-00248 North Carolina
Allopathic & Osteopathic Physicians / Surgery 208600000X 32228 Alabama

Profile Details

NPI number 1255511572
LBN Legal business name Cooper, Jack Marshall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2007
Last updated Jan 5th, 2023 - about 3 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 1255511572 NPPES
North Carolina MEDICAID 5920296
North Carolina MEDICAID 149171

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