Provider Demographics
NPI:1861454977
Name:COGGINS, ALLAHNA ALLYBIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAHNA
Middle Name:ALLYBIA
Last Name:COGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:101 HARRIS INDUSTRIAL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-8852
Mailing Address - Country:US
Mailing Address - Phone:912-537-1014
Mailing Address - Fax:912-538-0979
Practice Address - Street 1:101 HARRIS INDUSTRIAL BLVD
Practice Address - Street 2:STE C
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8852
Practice Address - Country:US
Practice Address - Phone:912-537-1014
Practice Address - Fax:912-538-0979
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27805207V00000X
GA73084207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA210973OtherSTATE LIMITED LISENCE
SC278050Medicaid
GA073084OtherSTATE LICENSE
SC27805OtherSTATE LISENCE
SC20-27805OtherSTATE CONTROLLED SUBST
SC20-27805OtherSTATE CONTROLLED SUBST
BC9217490OtherFEDERAL DEA