Dr Jerry D Cooper, DPM | |
2565 Channing Way, Idaho Falls, ID 83404-7516 | |
(208) 523-2928 | |
(208) 523-2962 |
Full Name | Dr Jerry D Cooper |
---|---|
Gender | Male |
Speciality | Podiatry |
Experience | 37 Years |
Location | 2565 Channing Way, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942299151 | NPI | - | NPPES |
001393600 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | P126 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Mountain View Hospital | Idaho falls, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mountain View Hospital Llc | 4486562774 | 188 |
Provider Name | Mountain View Hospital Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343 |
Mailing Address | Practice Location Address |
---|---|
Dr Jerry D Cooper, DPM 2565 Channing Way, Idaho Falls, ID 83404-7516 Ph: (208) 523-2928 | Dr Jerry D Cooper, DPM 2565 Channing Way, Idaho Falls, ID 83404-7516 Ph: (208) 523-2928 |
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