Provider Demographics
NPI:1407963705
Name:COTTON, DONALD R (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:COTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3810
Mailing Address - Country:US
Mailing Address - Phone:417-347-4800
Mailing Address - Fax:417-347-4033
Practice Address - Street 1:3315 MCINTOSH CIRCLE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3649
Practice Address - Country:US
Practice Address - Phone:417-347-4800
Practice Address - Fax:417-347-4033
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR5211208600000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOZ43419306Medicaid
OK1111220Medicaid
KS703181OtherBLUE CROSS
OK1111220Medicaid
MO053050049Medicare ID - Type Unspecified