IndividualActive
Jerry Cooper, D.P.M.
NPI 1942299151 · Podiatrist · Idaho Falls, ID
Provider details
- NPI number
- 1942299151
- Entity type
- Individual
- Primary specialty
- PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- D.P.M.
- Sex
- Male
- Sole proprietor
- Yes
- License
- P126 (ID)
Practice location
2565 Channing Way
Idaho Falls, ID 83404-7516
Phone: (208) 523-2928
Fax: (208) 523-2962
Mailing address
2565 Channing Way
Idaho Falls, ID 83404-7516
Registry dates
- Enumerated
- 2005-10-19
- Last updated
- 2013-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.