Provider Demographics
NPI:1306985569
Name:COOPER, JAMES KEITH (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:KEITH
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 FRENCH PARK DR
Mailing Address - Street 2:STE E
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7291
Mailing Address - Country:US
Mailing Address - Phone:405-285-6901
Mailing Address - Fax:405-285-6902
Practice Address - Street 1:3509 FRENCH PARK DR
Practice Address - Street 2:STE E
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7291
Practice Address - Country:US
Practice Address - Phone:405-285-6901
Practice Address - Fax:405-285-6902
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK200702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology