Organization
J COFFEY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY ANN COFFEY (OFFICE MANAGER)
(580) 225-9222
Entity
Organization
Contact information
Practice address
1900 W 2ND ST, SUITE C, ELK CITY, OK 73644-4328
(580) 225-9222
(580) 225-1027
Mailing address
1900 W 2ND ST STE C, ELK CITY, OK 73644-4328
(580) 225-9222
(866) 835-6543
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20836
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100136650A
—
OK
05
—
100136650C
—
OK
05
—
100136650D
—
OK
01
—
20836
MEDICAL LICENSE NUMBER
OK
01
—
37D0963547
CLIA WAIVER NUMBER
OK
01
—
448604592-001
BC BS OF OK PROVIDER ID
OK
Enumeration date
08/31/2006
Last updated
01/30/2026
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