| Doctor Name: | COOPER L TERRY |
| NPI Number: | 1407887797 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 14854 |
| Business Practice Address: | 497 Azalea Dr Suite 102 Oxford, MS - 386557905 |
| Business Phone Number: | 6625132000 |
| Business Fax Number: | 6625132001 |
| Mailing Address: | 497 Azalea Dr, Suite 102 OXFORD |
| State: | MS |
| Postal Code: | 386557905 |
| Phone Number: | 6625132000 |
| Fax Number: | 6625132001 |
| NPI Enumeration Date: | 07/05/2006 |
| NPI Last Update Date: | 04/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 14854 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |