Individual
ERNEST L COBURN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
315 FALLS DR NW, ABINGDON, VA 24210-8093
(276) 739-7989
Mailing address
315 FALLS DR NW, ABINGDON, VA 24210-8093
(276) 739-7989
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101023208
VA
2085R0202X
Diagnostic Radiology Physician
19885
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64096902
—
KY
Enumeration date
08/09/2005
Last updated
01/20/2012
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