Provider Demographics
NPI:1891747291
Name:COOLEY, VERNON J (MD)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:J
Last Name:COOLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:900 ROUND VALLEY DR
Mailing Address - Street 2:# 100
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-7552
Mailing Address - Country:US
Mailing Address - Phone:435-655-6600
Mailing Address - Fax:435-655-2388
Practice Address - Street 1:1820 SIDEWINDER DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7492
Practice Address - Country:US
Practice Address - Phone:435-655-6600
Practice Address - Fax:435-655-2388
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2018-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT321332-1205207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT60842OtherPUBLIC EMPLOYEES HEALTH P
UT187251500OtherUS DEPT OF LABOR
UT841433992CO1OtherEDUCATORS MUTUAL
UT107007620101OtherSELECT HEALTH PLANS
UT09-00136OtherUNITED HEALTH CARE
UTTPRA09041OtherMOLINA ADVANTAGE