Individual
RICKY COTTRELL
Active
Individual
RICKY COTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01049885
IN
207L00000X
Anesthesiology Physician
Primary
01049885A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001566078
ANTHEM PTAN
IN
01
—
1102228267
ANTHEM PTAN
IN
05
—
200520280
—
IN
01
—
Q00160162
RAILROAD PTAN
IN
Enumeration date
03/25/2006
Last updated
11/27/2024
Update your record
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