Provider Demographics
NPI:1619136249
Name:COOPER, LAWRENCE ERWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ERWIN
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1150 LAKE HEARN DR NE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1522
Mailing Address - Country:US
Mailing Address - Phone:404-705-5000
Mailing Address - Fax:404-705-5060
Practice Address - Street 1:1150 LAKE HEARN DR NE
Practice Address - Street 2:SUITE 650
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1522
Practice Address - Country:US
Practice Address - Phone:404-705-5000
Practice Address - Fax:404-705-5060
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA021444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine