1. Home
  2. Directory
  3. Arizona
  4. Phoenix
  5. Specialist
  6. NPI Profile

MR. DETRICK MARK COOTER
NPI 1295560688
Specialist in Phoenix, AZ

Active since September 04, 2024
406 E MCLELLAN BLVD, PHOENIX, AZ 85012(505) 620-3864 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Detrick Mark Cooter NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DETRICK MARK COOTER (NPI 1295560688) is an individual specialist in Phoenix, Arizona, licensed in District Of Columbia (CSP40000064) and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1295560688
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameMR. DETRICK MARK COOTER
Location Address406 E MCLELLAN BLVDPhoenix, AZ 85012-1038
Mailing Address406 E Mclellan BlvdPhoenix, AZ 85012-1038 · (505) 620-3864
Phone(505) 620-3864
Sole ProprietorYes
Enumeration DateSeptember 4, 2024
NPPES CertifiedSeptember 4, 2024
✔ NPI 1295560688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in DC · CSP40000064
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
406 E MCLELLAN BLVD, Phoenix, AZ 85012
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Detrick Cooter's NPI number?

The NPI number for Detrick Cooter is 1295560688. It was assigned to this individual provider in the NPPES registry on September 4, 2024.

Where is Detrick Cooter located?

Detrick Cooter practices at 406 E Mclellan Blvd, Phoenix, AZ 85012. The listed phone number is (505) 620-3864.

What is Detrick Cooter's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Detrick Cooter was last updated on September 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.