William H Cooper, MD

Individual provider Active NPI Neurology Physician · Monte Vista, CO

NPI 1629186010 · NPPES record last updated May 5, 2021

Key facts

NPI
1629186010
Entity type
Individual (NPI type 1)
Primary specialty
Neurology Physician 2084N0400X
License
25191 (CO)
Practice address
103 Chico CT
Monte Vista, CO 81144-1065
Phone
(719) 852-9400
Fax
(719) 852-9311
NPI assigned
Aug 27, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01034275INMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Hospital Association of the San Luis Valley Past
since Jun 5, 2014
Accepting new patients
American Health Network of Indiana LLC Past Accepting new patients
Lutheran Hospital Association of the San Luis Valley Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01034275 IN
Neurology Physician 2084N0400X 25191 CO Yes

Addresses

Primary practice location

103 Chico CT
Monte Vista, CO 81144-1065

Mailing address

106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 587-1417

Other identifiers

IdentifierTypeStateIssuer
100334010MedicaidIN

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address neu.wcooper@direct.slvrmc.org Direct

Other providers in Monte Vista, CO

All providers in Monte Vista, CO · Neurology Physician in Colorado

Sources for this page

Verify at the official NPI Registry.