Dr Robert Wayne Cooper, MD | |
475 N Highway 25 W # Wn, Suite 100, Williamsburg, KY 40769-1576 | |
(606) 549-2933 | |
(606) 549-3036 |
Full Name | Dr Robert Wayne Cooper |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 475 N Highway 25 W # Wn, Williamsburg, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194729525 | NPI | - | NPPES |
115556 | Other | MO | HEALTHLINK |
3518 | Other | MO | BLUE CROSS/BLUE SHIELD |
7100398340 | Medicaid | KY | |
P00792573 | Other | MO | RAIL ROAD MEDICARE |
Q020836 | Medicaid | TN | |
135570021 | Other | MO | MEDICARE PTAN |
201533510 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 18598 (Kentucky) | Primary |
207Q00000X | Family Medicine | 53545 (Tennessee) | Secondary |
Entity Name | Williamsburg Family Medicine Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376689620 PECOS PAC ID: 2365331188 Enrollment ID: O20041108001285 |
Mailing Address | Practice Location Address |
---|---|
Dr Robert Wayne Cooper, MD Po Box 247, Jellico, TN 37762-0247 Ph: (606) 549-2933 | Dr Robert Wayne Cooper, MD 475 N Highway 25 W # Wn, Suite 100, Williamsburg, KY 40769-1576 Ph: (606) 549-2933 |
Nathaniel Douglas Dillon, MSN, APRN, FNP-C Family Medicine Medicare: Medicare Enrolled Practice Location: 65 N Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-0123 | |
Thomas Doncaster, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 475 N Highway 25 W, Suite 100, Williamsburg, KY 40769 Phone: 606-549-2933 Fax: 606-549-3036 | |
Dr. Richard W Bailey, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 686 S Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-5052 Fax: 606-549-2718 | |
Dr. Travis Jordan Sulfridge, DVM Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 319 Tackett Creek Rd, Williamsburg, KY 40769 Phone: 606-549-5444 | |
Mr. Robert Lee Penn, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 998 S Highway 25 W, Williamsburg, KY 40769 Phone: 606-549-8154 | |
Dr. James Wendall Killian, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 402 Cumberland Ave, Williamsburg, KY 40769 Phone: 606-549-2656 Fax: 606-549-2855 |