Individual
DR. KENNETH PAUL COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 E ROBINSON ST, NORMAN, OK 73071-6610
(405) 364-7900
(405) 366-6214
Mailing address
4500 S GARNETT RD, STE 919, TULSA, OK 74146-5214
(405) 364-7900
(405) 366-6214
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
10847
OK
2085R0202X
Diagnostic Radiology Physician
Primary
10847
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10010020A
—
OK
01
—
300034744
RR MEDICARE
OK
Enumeration date
07/13/2005
Last updated
01/02/2019
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