Basic Information
| Provider Information | |||||||||
| NPI: | 1174919617 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | LEWIS | ||||||||
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| OtherLastName: | LEWIS | ||||||||
| OtherFirstName: | LAUREN | ||||||||
| OtherMiddleName: | BETH | ||||||||
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| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 133 HOSPITAL DR STE 500 | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370304020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157350700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 133 HOSPITAL DR STE 500 | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157350700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2015 | ||||||||
| LastUpdateDate: | 06/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DO0000003283 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.