Provider Demographics
NPI:1942321195
Name:COOPER, WILLIAM ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:COOPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:STRINGTOWN
Mailing Address - State:OK
Mailing Address - Zip Code:74569-0220
Mailing Address - Country:US
Mailing Address - Phone:580-346-7373
Mailing Address - Fax:580-346-7374
Practice Address - Street 1:HWY 69
Practice Address - Street 2:OKLAHOMA DEPARTMENT OF CORRECTIONS
Practice Address - City:STRINGTOWN
Practice Address - State:OK
Practice Address - Zip Code:74569-0220
Practice Address - Country:US
Practice Address - Phone:580-346-7373
Practice Address - Fax:580-346-7374
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine