Provider Demographics
NPI:1467905273
Name:LLOYD A. COAKER, MD, PC
Entity Type:Organization
Organization Name:LLOYD A. COAKER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:A
Authorized Official - Last Name:COAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-792-2908
Mailing Address - Street 1:PO BOX 35760
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85740-5760
Mailing Address - Country:US
Mailing Address - Phone:520-722-0777
Mailing Address - Fax:520-290-9713
Practice Address - Street 1:1775 W SAINT MARYS RD
Practice Address - Street 2:SUITE 114
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2696
Practice Address - Country:US
Practice Address - Phone:520-792-2908
Practice Address - Fax:520-624-6876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11272207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPENDINGMedicare PIN