Provider Demographics
NPI:1629207048
Name:COKER, CHRISTOPHER DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:COKER
Suffix:
Gender:M
Credentials:OD
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Other - First Name:
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Mailing Address - Street 1:2055 E WINDMILL LN
Mailing Address - Street 2:STE 105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2066
Mailing Address - Country:US
Mailing Address - Phone:702-731-2233
Mailing Address - Fax:702-450-6116
Practice Address - Street 1:2055 E WINDMILL LN
Practice Address - Street 2:STE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2066
Practice Address - Country:US
Practice Address - Phone:702-731-2233
Practice Address - Fax:702-450-6116
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV641152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVGE399ZMedicare UPIN