Individual
DR. COY JOE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E DOWNING ST, SUITE 205, TAHLEQUAH, OK 74464-3234
(918) 456-0592
(918) 456-0252
Mailing address
1500 E DOWNING ST, SUITE 205, TAHLEQUAH, OK 74464-3234
(918) 456-0592
(918) 456-0252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11222
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548201155
MEDICARE NPI
OK
Enumeration date
06/08/2006
Last updated
07/20/2010
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