Provider Demographics
NPI:1497703268
Name:COE, CYNTHIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:COE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66239
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70896-6239
Mailing Address - Country:US
Mailing Address - Phone:225-746-9744
Mailing Address - Fax:225-267-6522
Practice Address - Street 1:4004 CONVENTION ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3807
Practice Address - Country:US
Practice Address - Phone:225-267-6509
Practice Address - Fax:225-267-6522
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1336106Medicaid
LA51404Medicare ID - Type UnspecifiedMEDICARE
LAB63037Medicare UPIN