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Organization
COKER PEDIATRICS LLC
Active
Organization
COKER PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALLEN COKER M.D. (MEMBER)
(678) 688-1580
Entity
Organization
Contact information
Practice address
14557 HIGHWAY 19, SUITE A, GRIFFIN, GA 30224-9582
(678) 688-1580
(678) 688-1594
Mailing address
14557 HIGHWAY 19, SUITE A, GRIFFIN, GA 30224-9582
(678) 688-1580
(678) 688-1594
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056276
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
579118048J
—
GA
Enumeration date
05/10/2007
Last updated
03/24/2014
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