Condace Dornella Cooper, LD is a
Dietitian, Registered based in Quitman, Georgia. Condace Dornella Cooper is licensed to practice in Georgia (license number LD003261) and her current practice location is
903 N Court St, Quitman, Georgia. She can be reached at her office (for appointments etc.) via phone at
(229) 263-4171.
NPI number for Condace Dornella Cooper is 1396987665 and her current mailing address is 920 Cairo Rd, Thomasville, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1396987665.
Healthcare Provider's Profile
Full Name | Condace Dornella Cooper |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 903 N Court St, Quitman, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1396987665
- Provider Enumeration Date: 04/01/2009
- Last Update Date: 04/01/2009
Medical Identifiers
Medical identifiers for Condace Dornella Cooper such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1396987665 | NPI | - | NPPES |
LD003261 | Other | GA | LICENSE |
925267 | Other | GA | REGISTERED DIETITIAN |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | LD003261 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Condace Dornella Cooper is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Condace Dornella Cooper, LD 920 Cairo Rd, Thomasville, GA 31792-4255 Ph: (229) 228-8800 | Condace Dornella Cooper, LD 903 N Court St, Quitman, GA 31643-1315 Ph: (229) 263-4171 |
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