Individual
KENNETH COGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5865-851
WI
207R00000X
Internal Medicine Physician
67177
WI
Other
Enumeration date
04/20/2015
Last updated
04/23/2017
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