Provider Demographics
NPI:1922283837
Name:COFFMAN AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:COFFMAN AND ASSOCIATES, INC.
Other - Org Name:MED-EVAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN
Authorized Official - Phone:405-706-4988
Mailing Address - Street 1:4631 N MAY AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6052
Mailing Address - Country:US
Mailing Address - Phone:405-840-2180
Mailing Address - Fax:405-456-6800
Practice Address - Street 1:4631 N MAY AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6052
Practice Address - Country:US
Practice Address - Phone:405-840-2180
Practice Address - Fax:405-456-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center