Provider Demographics
NPI:1528134582
Name:COOLEY, DAVID ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:COOLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:830 W HIGH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3971
Mailing Address - Country:US
Mailing Address - Phone:419-229-8928
Mailing Address - Fax:419-229-5291
Practice Address - Street 1:1003 BELLEFONTAINE AVE STE 100
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1868
Practice Address - Country:US
Practice Address - Phone:419-998-8234
Practice Address - Fax:419-998-8233
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35049465207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341712408OtherOTHER INS
341712408OtherTRICARE
OH0859441Medicaid
OHCL1312OtherMEDICARE RAILROAD
OH000000137184OtherANTHEM BLUE CROSS
OHH076131Medicare PIN
OHCL1312OtherMEDICARE RAILROAD