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Organization

COFAS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES KEITH COFAS MD (OWNER/MD)
(541) 882-3818
Entity
Organization

Contact information

Practice address
2218 SHALLOCK AVE, KLAMATH FALLS, OR 97601-4290
(541) 882-3818
(541) 882-9800
Mailing address
2218 SHALLOCK AVE, KLAMATH FALLS, OR 97601-4290
(541) 882-3818
(541) 882-9800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD11585
OR
207R00000X
Internal Medicine Physician
Primary
MD25846
OR
363A00000X
Physician Assistant
PA01446
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
027754
OR
01
DE8224
RAILROAD MEDICARE
OR
Enumeration date
03/27/2006
Last updated
05/16/2019
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