Provider Demographics
NPI:1598798902
Name:COONCE, DANIEL FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FRANCIS
Last Name:COONCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N WASHINGTON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2623
Mailing Address - Country:US
Mailing Address - Phone:931-528-2443
Mailing Address - Fax:931-528-1488
Practice Address - Street 1:315 N WASHINGTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2603
Practice Address - Country:US
Practice Address - Phone:931-528-2443
Practice Address - Fax:931-528-1488
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD99932085R0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3134538OtherTN BCBS
TN3035368Medicaid
TN3035368Medicaid
TNA99916Medicare UPIN