Provider Demographics
NPI:1063510931
Name:COOPER, JOHN H (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 440441
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0441
Mailing Address - Country:US
Mailing Address - Phone:865-544-6500
Mailing Address - Fax:865-544-6509
Practice Address - Street 1:1932 ALCOA HIGHWAY
Practice Address - Street 2:BUILDING C SUITE 570
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-544-6500
Practice Address - Fax:865-544-6509
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3159670Medicare ID - Type Unspecified
D70173Medicare UPIN