Individual
DR. THOMAS FRED COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 RICE ST, WILMORE, KY 40390-1359
(859) 858-9355
(859) 858-0416
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31991
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64319916
—
KY
Enumeration date
01/13/2006
Last updated
07/11/2019
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