Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Mary Lane Cooper, PA/C

Individual provider Medical Physician Assistant · NPI 1508116765

Mrs. Mary Lane Cooper, PA/C is a Medical Physician Assistant in Claxton, Georgia. Licensed in Georgia. Registered with an NPI since 2012.

Licensed in
GA
In the registry since
2012

Practice location Address checks out

3609 Bill Hodges Rd
Claxton, GA 30417-6235
Phone: (912) 739-4807
Fax: (912) 739-2939
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 1586 (GA)

Record details

NPI number1508116765
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA/C
Sole proprietorNo
NPI enumeratedSeptember 14, 2012
Last updated in NPPESSeptember 14, 2012

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