Provider Demographics
NPI:1811952716
Name:COOPER, MATTHEW MARC (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MARC
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3310
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:918-488-6010
Practice Address - Street 1:6151 S YALE AVE
Practice Address - Street 2:SUITE 1301
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1907
Practice Address - Country:US
Practice Address - Phone:918-502-3200
Practice Address - Fax:918-502-3205
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2009-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV7037208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF26748Medicare UPIN
OKOK400243Medicare PIN