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Individual

MS. NICOLE R COSSAART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
Mailing address
708 NW 40TH ST, OKLAHOMA CITY, OK 73118-7046

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
22862
OK
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
22862
OK
207RP1001X
Pulmonary Disease Physician
22862
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200070210A
OK
Enumeration date
05/11/2006
Last updated
01/13/2021
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