Provider Demographics
NPI:1821057845
Name:COOPER, KATHARINE R (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:R
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3368 HIGHWAY 280
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010
Mailing Address - Country:US
Mailing Address - Phone:256-234-2464
Mailing Address - Fax:256-234-2440
Practice Address - Street 1:3368 HIGHWAY 280
Practice Address - Street 2:SUITE 205
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3393
Practice Address - Country:US
Practice Address - Phone:256-234-2464
Practice Address - Fax:256-234-2440
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2008-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL18123207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009937370Medicaid
AL631257919OtherUNITED HEALTHCARE
AL631257919OtherCHAMPUS/TRICARE
AL631257919OtherCOMMERCIAL INSURANCE CO.
AL98417OtherBCBS
AL009937370Medicaid
AL98417OtherBCBS