| Doctor Name: | DR. TANA KATHRYN COOPER |
| NPI Number: | 1174730519 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 20540 |
| Business Practice Address: | 3680 Sangani Blvd Ste H2 Diberville, MS - 395408709 |
| Business Phone Number: | 2283549300 |
| Business Fax Number: | 2283549301 |
| Mailing Address: | 10243 Belle Vue Rd, DIBERVILLE |
| State: | MS |
| Postal Code: | 395404654 |
| Phone Number: | 2282973967 |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 10/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 20540 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |