Provider Demographics
NPI:1801231717
Name:COKER AND QUALLS, PA
Entity Type:Organization
Organization Name:COKER AND QUALLS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-917-3319
Mailing Address - Street 1:115 MEDICAL CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-9124
Mailing Address - Country:US
Mailing Address - Phone:601-917-3319
Mailing Address - Fax:
Practice Address - Street 1:115 MEDICAL CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-9124
Practice Address - Country:US
Practice Address - Phone:601-917-3319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty