ENT & Facial Plastic Surgery, P.a.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

C10002552 Issued in DE

Legal business name

ENT & FACIAL PLASTIC SURGERY, P.A.

Practice address

826 S Governors Ave
Dover, DE 19904-4107

Phone

(302) 674-3752

Fax

(302) 674-8521

NPI assigned

Nov 16, 2006

Last updated

Aug 8, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephen G Cooper, M.D.,

Title

President

Phone

(302) 674-3752

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1295808590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 S GOVERNORS AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044107",
            "telephone_number": "302-674-3752",
            "fax_number": "302-674-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 S GOVERNORS AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044107",
            "telephone_number": "302-674-3752",
            "fax_number": "302-674-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT & FACIAL PLASTIC SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-674-3752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "DE",
            "license": "C10002552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000221602",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.