Cooper, Timothy R

Cooper, Timothy R is an individual health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Cooper, Timothy R can be contacted via phone (877) 229-0273.

Contact Information

Primary practice address
2845 Greenbrier Rd Green Bay WI 54311-6519
Phone: (877) 229-0273
Fax: (920) 288-4863
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 33935 Wisconsin
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 33935-020 Wisconsin

Profile Details

NPI number 1033192943
LBN Legal business name Cooper, Timothy R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Apr 9th, 2024 - about last year

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 1033192943 NPPES
Michigan MEDICAID 104896578
Michigan Other P00355798
Michigan MEDICAID 32037400

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