Provider Demographics
NPI:1972515898
Name:JOE E. COKER, M.D.P.C.
Entity Type:Organization
Organization Name:JOE E. COKER, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-243-2200
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-0567
Mailing Address - Country:US
Mailing Address - Phone:580-243-2200
Mailing Address - Fax:580-243-0812
Practice Address - Street 1:1800 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-3133
Practice Address - Country:US
Practice Address - Phone:580-243-2200
Practice Address - Fax:580-243-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12529208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1114951605Medicare ID - Type UnspecifiedNPI