Individual provider · Type 1 NPI
Mary Lane Cooper, PA/C
Medical Physician Assistant · Claxton, GA
NPI number
1508116765
Active
Practice location
3609 Bill Hodges Rd
Claxton, GA 30417-6235
Fax (912) 739-2939
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1586 (GA) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Claxton
About NPI 1508116765
Mary Lane Cooper, PA/C's National Provider Identifier is 1508116765, issued on Sep 14, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Claxton, GA. The record was last updated on Sep 14, 2012.