Provider Demographics
NPI:1609982412
Name:COOPER, ROBERT FRANKLIN III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANKLIN
Last Name:COOPER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2200 S LAMAR BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5200
Mailing Address - Country:US
Mailing Address - Phone:662-234-1121
Mailing Address - Fax:662-236-2261
Practice Address - Street 1:2200 S LAMAR BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5200
Practice Address - Country:US
Practice Address - Phone:662-234-1121
Practice Address - Fax:662-236-2261
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-09-08
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Provider Licenses
StateLicense IDTaxonomies
MS07642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00016342Medicaid
MS00016342Medicaid
MSC48002Medicare UPIN