Provider Demographics
NPI:1154499499
Name:COOPER, JONAS AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:JONAS
Middle Name:AARON
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:121 SAINT LUKES CENTER DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3518
Mailing Address - Country:US
Mailing Address - Phone:636-685-7738
Mailing Address - Fax:314-590-5927
Practice Address - Street 1:121 SAINT LUKES CENTER DR STE 404
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3519
Practice Address - Country:US
Practice Address - Phone:636-685-7738
Practice Address - Fax:314-590-5927
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018040207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1154499499Medicaid
PA1024071030001Medicaid
PAP00864178Medicare PIN
PA1024071030001Medicaid
PACJ7556Medicare UPIN