Provider Demographics
NPI:1235641010
Name:COGGINS, DARIN (DPH)
Entity Type:Individual
Prefix:DR
First Name:DARIN
Middle Name:
Last Name:COGGINS
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:DR
Other - First Name:DARIN
Other - Middle Name:
Other - Last Name:COGGINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPH
Mailing Address - Street 1:13051 E 134TH PL N
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-4474
Mailing Address - Country:US
Mailing Address - Phone:918-691-8714
Mailing Address - Fax:
Practice Address - Street 1:115 W 3RD ST UNIT 820
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3410
Practice Address - Country:US
Practice Address - Phone:918-585-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist