Provider Demographics
NPI:1528067477
Name:COOL, JENNIFER L (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:COOL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10450 E RIGGS RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-7758
Mailing Address - Country:US
Mailing Address - Phone:480-895-7600
Mailing Address - Fax:480-895-7601
Practice Address - Street 1:10450 E RIGGS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-7758
Practice Address - Country:US
Practice Address - Phone:480-895-7600
Practice Address - Fax:480-895-7601
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-12-16
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Provider Licenses
StateLicense IDTaxonomies
AZ31073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ763640Medicaid
AZG59894Medicare UPIN
AZ763640Medicaid