Provider Demographics
NPI:1275682452
Name:COTTINGHAM, CHRISTINA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LYNN
Last Name:COTTINGHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2556 WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2464
Mailing Address - Country:US
Mailing Address - Phone:270-830-7150
Mailing Address - Fax:
Practice Address - Street 1:5405 PEARL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-8102
Practice Address - Country:US
Practice Address - Phone:812-426-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003273152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V01441Medicare UPIN