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Individual

DR. KENNETH PAUL COFFEY

Active
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Individual

DR. KENNETH PAUL COFFEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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
Update your record

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