Provider Demographics
NPI:1144410952
Name:COOPER, WILLIAM ARTHUR (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:COOPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 TRINITY OAKS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4409
Mailing Address - Country:US
Mailing Address - Phone:813-264-6490
Mailing Address - Fax:813-443-8143
Practice Address - Street 1:2102 TRINITY OAKS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4409
Practice Address - Country:US
Practice Address - Phone:813-264-6490
Practice Address - Fax:813-443-8143
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202797207X00000X
NE539207X00000X
FLOS13775207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIQ606ZMedicare UPIN
VAVVG149AMedicare PIN