Sandusky, Walter Cooper

Sandusky, Walter Cooper is an sole proprietor health care provider with primary practice located at 6262 Poplar Ave , Memphis TN 38119-4728. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Sandusky, Walter Cooper can be contacted via phone (901) 761-3700.

Contact Information

Primary practice address
6262 Poplar Ave Memphis TN 38119-4728
Phone: (901) 761-3700
Fax: (901) 680-0403
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 3809 Tennessee

Profile Details

NPI number 1780722959
LBN Legal business name Sandusky, Walter Cooper
Credentials DDS, MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 8th, 2007 - about 19 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 1780722959 NPPES
Tennessee Other 0037820 BCBS OF TENNSSEE
Tennessee Other 832857 BCBS OF TENNSSEE

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