Individual
DR. EDWIN L. COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-5362
(479) 441-4868
Mailing address
PO BOX 1824, FORT SMITH, AR 72902-1824
(479) 709-7399
(479) 709-7053
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C2686
AR
208D00000X
General Practice Physician
Primary
C2686
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078260A
—
OK
05
—
105564001
MEDICAID PROVIDER NUMBER
AR
01
—
51096
ARKANSAS BCBS
AR
Enumeration date
07/13/2005
Last updated
10/02/2008
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