Provider Demographics
NPI:1811076300
Name:COOPERMAN, JOEL B (DO)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:B
Last Name:COOPERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:10555 E DARTMOUTH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2645
Mailing Address - Country:US
Mailing Address - Phone:303-991-4651
Mailing Address - Fax:303-991-3300
Practice Address - Street 1:10555 E DARTMOUTH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2645
Practice Address - Country:US
Practice Address - Phone:303-991-4651
Practice Address - Fax:303-991-3300
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2008-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO22411204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO501008Medicare PIN
COE40910Medicare UPIN