Provider Demographics
NPI:1639133424
Name:COOPER, JAMES CLAUDE JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CLAUDE
Last Name:COOPER
Suffix:JR
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 1:3209 E. ZION RD.
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764
Mailing Address - Country:US
Mailing Address - Phone:479-872-6558
Mailing Address - Fax:479-571-4015
Practice Address - Street 1:38 W. SUNBRIDGE
Practice Address - Street 2:VA HOSPITAL
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-684-2900
Practice Address - Fax:479-571-4015
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1164207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR175440000OtherQUALCHOICE
AR4054557OtherAETNA
MO244813101Medicaid
ARB033OtherCHAMPUS
AR293392OtherUNITED HEALTHCARE
AR131237003Medicaid
ARE1164OtherSTATE LICENSE
OK100134720AMedicaid
OK100134720AMedicaid
ARB033OtherCHAMPUS
OK100134720AMedicaid
AR060051128Medicare PIN