Cooper, Sally A.
Cooper, Sally A. is an individual health care provider with primary practice located at 221 Hospital Dr Ne , Fort Walton Beach FL 32548-5066. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Cooper, Sally A. can be contacted via phone (850) 833-9240.Contact Information
Primary practice address
221 Hospital Dr Ne
Fort Walton Beach FL 32548-5066
Phone: (850) 833-9240
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS9434 | Florida |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | OS9434 | Florida |
Profile Details
| NPI number | 1487646725 |
|---|---|
| LBN Legal business name | Cooper, Sally A. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Jul 28th, 2011 - about 15 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 | 1487646725 | NPPES |
| Florida | MEDICAID | 273692600 | |
| Florida | Other | 059197876 | |
| Florida | Other | 28660 |
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