Provider Demographics
NPI:1427182781
Name:COTANT, CASEY LEE (MD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:LEE
Last Name:COTANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-6100
Mailing Address - Fax:208-625-6101
Practice Address - Street 1:700 W IRONWOOD DR STE 375
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4401
Practice Address - Country:US
Practice Address - Phone:208-625-6100
Practice Address - Fax:208-625-6101
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM15124207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology