Provider Demographics
NPI:1083667885
Name:COOLEY, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:COOLEY
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:12330 METCALF AVE
Mailing Address - Street 2:SUITE 570
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1324
Mailing Address - Country:US
Mailing Address - Phone:913-661-9990
Mailing Address - Fax:913-661-9963
Practice Address - Street 1:12330 METCALF AVE
Practice Address - Street 2:SUITE 570
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:913-661-9990
Practice Address - Fax:913-661-9963
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0414858207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSC50408Medicare UPIN
KSP624569Medicare ID - Type Unspecified