Cooper, Jerry Dewayne
Cooper, Jerry Dewayne is an individual health care provider with primary practice located at 275 Collier Rd Nw Suite 290, Atlanta GA 30309-1709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Cooper, Jerry Dewayne can be contacted via phone (404) 352-3300.Contact Information
Primary practice address
275 Collier Rd Nw Suite 290
Atlanta GA 30309-1709
Phone: (404) 352-3300
Fax: (404) 352-9453
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 013262 | Georgia |
Profile Details
| NPI number | 1396728598 |
|---|---|
| LBN Legal business name | Cooper, Jerry Dewayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Mar 26th, 2013 - about 13 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 | 1396728598 | NPPES |
| Georgia | MEDICAID | 00134142G |
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