Cooper, Shelby O.

Cooper, Shelby O. is an individual health care provider with primary practice located at 207 N Townline Rd Ste 204 , Lagrange IN 46761-1325. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Cooper, Shelby O. can be contacted via phone (260) 463-9470.

Contact Information

Primary practice address
207 N Townline Rd Ste 204 Lagrange IN 46761-1325
Phone: (260) 463-9470
Fax: (260) 665-7312
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 01021456 Indiana
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01021456A Indiana

Profile Details

NPI number 1568551414
LBN Legal business name Cooper, Shelby O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Oct 10th, 2022 - about 4 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 1568551414 NPPES
Indiana MEDICAID 100408010

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