Provider Demographics
NPI:1831127513
Name:COCO, JEFFERY W (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:W
Last Name:COCO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3525 PRYTANIA ST
Mailing Address - Street 2:SUITE 526
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3500
Mailing Address - Country:US
Mailing Address - Phone:504-648-2520
Mailing Address - Fax:504-897-2064
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:SUITE 526
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-648-2520
Practice Address - Fax:504-897-2064
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-04-12
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Provider Licenses
StateLicense IDTaxonomies
LA018181207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1146081Medicaid
LA1146081Medicaid
BC0241961OtherFEDERAL DEA
LA5N171Medicare PIN